Trans Defense Fund LA
PLEASE READ EVERYTHING BELOW.
🛑 DO NOT fill this form out if you are cis. This resource is strictly for QTBIPOC. Priority will be given to Black trans femmes, QTBIPOC sex workers and/or those who are disabled. Priority will be given to those at the intersections of the above identities. Must be 18+ to apply. 🛑
Filling out this form does not guarantee a self-defense kit❗ We prioritize folks based on their demographics and our supply level which is influenced by the monetary donations we receive. If you do not receive a kit, we will keep you in mind for future kit distribution efforts.
If you have already received a kit before, please allow others to have this opportunity. Please do not apply on behalf of someone else. If you have any questions, you can reach out to us personally.
When we are able to supply you a kit, you will receive either a text, dm, or email from us with the next steps on how to place an order for your kit. Please provide correct contact information. This process may take months as we are a very tiny team. Thank you!
If you have any questions contact us at
Sign in to Google
to save your progress.
Full name or alias
What is your race or ethnicity?
Please select multiple if more than one of the following applies to you.
Indigenous / Native / Aboriginal
Multiracial or Multiethnic
Hispanic or Latinx
How do you identify?
(i.e. Trans woman, Non-binary femme, Two-Spirit, etc.)
Are you a sex worker?
Are you disabled?
You must be in the U.S. to be eligible to receive a package. Please include your full address, including unit number (if it applies), city, state, and zip code. Your home address will not be shared with anybody else outside of our team.
Instagram handle or other social profile
How did you hear about us?
Are there any other tools or resources you think would be useful?
Send me a copy of my responses.
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google.
Terms of Service