Self-Defense Kit Reservation Form
Reserve a free self-defense kit from Asian Defense Fund! For more information, check out our website:

***We ask that you please do not fill out this form if you are not part of the Asian community, unless you are ordering on behalf of somebody else that is. Priority will be given to Asian elders, sex workers, Black and Brown Asians, and the unhoused. If you have the financial means to purchase your own self-defense items, we ask that you do not fill out this form, so that kits could go toward those who cannot afford them. The recipient of this kit must be 18+ years old.***

Filling out this form does not guarantee receiving a self-defense kit. We will be prioritizing folks based on their demographic group and our inventory. Our first batch of 250 kits are now fully reserved, but we are still accepting reservations for future batches (when we gather enough donations).

Our kits will include:
• Alarm Keychain
• Pepper Spray
• Stun Gun
• Reusable clear zip bag with strap
• An instructional pamphlet in various languages

If you have any questions/concerns, feel free to reach out to us via or on Instagram
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Email *
Are you ordering a self-defense kit for yourself, or on behalf of somebody you know? *
Full name of the recipient *
Does the recipient identify as any of the following priority groups? *
What language does the recipient prefer to read in? *
We are asking this to inform which instructional pamphlet translation we should include in the self-defense kit.
Address for delivery *
You must be located in California to be eligible to receive a package. Please include the recipient's full shipping address, including unit number (if applicable), city, state, and zip code. This address will not be shared with anybody outside of our team.
Are there any other tools or resources you think would be useful?
Examples: whistle, tactical flashlight, in-person self-defense classes, etc.
How did you find out about Asian Defense Fund?
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Thank you for requesting a kit!
We keep us safe. (҂◡̀_◡́) ᕤ
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