Cal COLA Mutual Aid / Financial Emergency Fund - Requests Form
***Please Read Before You Fill Out This Form***
**Before you fill out this form, please join the mutual aid platform by joining this Google Group:
. You can keep up to date on existing programs and resources and familiarize yourself with the ethos behind this program here.
*To help us direct funding to the most urgent cases, please fill this out only if you have examined the other resources listed below and have found that they either do not apply to you or that they are otherwise insufficient to meet your immediate needs.
Below are UCB campus resources that may be of assistance to you in the interim. If you have exhausted these avenues or have found them insufficient, please discuss your experience in the "Anything else we should know" section of this form.
***Direct Financial Assistance (Gift Aid and Loans):
1) For ALL enrolled students who have a financial need for the Spring 2020 term as a result of COVID-19, you may be eligible for relief funds to support your housing, food, technology, and/or medical/health needs. You need to be logged into a
email account to access this page:
2) For Undocumented Students (both G and U):
3) Short-term Emergency Loans:
4) For students with dependents:
Grocery Bag Deliveries (Spring and Summer 2020):
ASUC Food Pantry Project:
Basic Needs Center Free Weekly Grocery Bag Sign-Up:
Food Assistance Program:
for DSP Students:
***Rental and Housing
Emergency Rental Assistance Program (Basic Needs Center):
SAO Rental Assistance Fund:
Security Deposit Assistance:
SAO Co-Pay Assistance Program:
Basic Needs Center Resources:
This form is for anyone associated with the extended community of UC Berkeley (undergraduates, students, workers, faculty, staff, and those under their care) who is seeking financial assistance or other forms of aid during the COVID-19 pandemic. Responses to this form will remain anonymous except to the organizers and the volunteers or donors with whom you are paired for assistance. Feel free to disseminate these forms widely.
If you would like to provide funds or services (childcare, petcare, transportation, supplies), please fill out this form:
if you have any questions/comments/concerns. We will try to match your requests with funds or a volunteer as quickly as possible.
Name and pronouns
Affiliation with UC Berkeley
Address (optional, but helpful if in need of deliveries, trans., etc.)
Are you over the age of 60?
Do you have a chronic condition which affects your immune system?
Have you had any flu-like symptoms in the past week?
I am seeking assistance with...
Picking up and delivering groceries, medical supplies, or other essential errands
Transportation to medical facilities (to avoid public transit)
Home cooked meals (dietary needs in "Other")
1-on-1 home visits, texts / online messaging, emotional support, or companionship
Help applying for social services (such as applying for health insurance)
Translation or Interpretation (please list language in "Other")
Tutoring / Schoolwork Assistance (describe in "Other")
Temporary / emergency housing
Please provide more details on the needs which you described above.
Do you have any accessibility needs? (ASL translator, wheelchair to car pivot transfer, etc)
Please answer the following: 1) Can you accept funds through PayPal? At the moment, this is our primary method of dispersing funds. Provide a PayPal ID, please! 2) What are you essential, weekly costs? In other words, what is the weekly amount that you need in order to meet the caloric, medical, and psychological needs of yourself and those who depend on you for care? 3) What would the maximum amount that you would receive in a dream scenario to help you shoulder your financial burdens during the pandemic?
Have you had experience with any of the above UCB resources mentioned in the description above? Have you experienced any shortcomings in these existing resources and how they are responding to the urgency of your needs? (Food Pantry, Emergency Loans, Rental Assistance Fund, Undocumented Services, Basic Needs Center groceries, etc)
Anything else we should know?
As we organize mutual aid networks we will also be putting together a petition demanding: a suspension of rent; refunding on-campus fees; cancelling, lessening the weight for, or making finals optional; access to mental health resources from counseling center that can be accessed remotely; more financial aid for undocumented students; compensation for workers who will lose their jobs or hours + ensuring appropriate paid sick time. Are there any other demands you would add to this list?
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