Name and/or Gender Marker Donation Request
Hello! Welcome to the Donation Request Form by Let's Get By Together (Queer Incorporated Association).

Please note: you can fill out this form for someone else. If you are, please include your information, and there will be a section at the end of this form where you could enter more information if you please.
Email address *
Is this application for yourself or someone else? *
If you are filling this application out for someone other than yourself, please specify your relationship.
Clear selection
Personal Information
Chosen Name
Legal Name *
Pronouns *
Date of Birth *
MM
/
DD
/
YYYY
Full Address *
Country *
Do you (or the person for whom you are filling out this form) identify within the LGBTQIA+ community? *
Feel free to specify, if you would like
Donation Information
Description of Donation Request *
What is the amount needed? *
Is the above a rough estimate or exact amount? *
If you picked: Rough Estimate
We will at some point need an exact amount, but it's okay if you don't know yet! You can also reach out to us at info@letsgetbytogether.org and we can help you research how much it will cost in your area! :)
Any additional information you would like to include
Legal Stuff
Let's Get By Together Inc. respects your personal and financial information and will not release information to the public in regards to prospective or actual donation requests or other names, gift amounts, stories, or designations without requested and written consent by the individual (yourself). If you have questions please email info@letsgetbytogether.org
Please check all boxes to confirm that *
Required
Comments
Submit
Never submit passwords through Google Forms.
reCAPTCHA
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy