Autistic People of Color Fund – EMERGENCY APPLICATION
Please ONLY use this version of the application if you are currently in crisis and your ask is for an emergency.

If you're looking for the full application, it's here: https://goo.gl/forms/4rmo1wxVjmO890BB2

*** This fund is for autistic people of color, not for parents, caregivers, or family members. Effective September 1st, 2020, parents, caregivers, and family members are no longer allowed to apply for funding.
Read more here: https://autismandrace.com/autistic-people-of-color-fund/2020-eligibility-policy-change/ ***

This fund is meant for autistic people of color applying for themselves – autistic youth of color and autistic adults of color. (This includes when an autistic person asks a trusted person to help fill out the application.)

It should take about 25 minutes on average to complete the application using this web form. There are 22 total questions beginning on the next page. Almost all of them are required.

*** We will do our best to respond to all crisis requests for funding within the next month after applying. We do our best to minimize gatekeeping as much as possible, unlike conventional grant-making and funding processes. ***

Email address *
(1) What is your name? *
This is the name that we should call you or the person you're applying for, even if your government or legal name is something different. Please note that this is your name if you are applying for yourself, but it is another person if you are applying for someone else.
(2) What is your legal name? *
We need this in case you need funds sent by check or electronic transfer, to an account with your legal name on it. We promise not to share it. Please note that this is your name if you are applying for yourself, but it is another person if you are applying for someone else.
(3) How should we contact you? *
Choose all that you are OK with.
Required
(4) What is your phone number, instant messenger platform and username, or other contact? *
(5a) Are there specific times or days we SHOULD contact you? *
(5b) Are there specific times or days we SHOULD NOT contact you? *
(6) Are you autistic? *
If you know you are autistic, but haven't received a professional/medical diagnosis, you still count. (Note that if you have a diagnosis, and you're wondering if it counts, there have been changes in labels -- if your diagnosis was "classic autism," "infantile autism," "Kanner's autism," "Asperger disorder," "pervasive developmental disorder, not otherwise specified," you definitely count. Some people whose diagnoses are "Rhett syndrome," "childhood disintegrative disorder," or "nonverbal learning disorder" may also be considered/consider themselves autistic too.)
(7) Are you a person of color? *
If you are white or have called yourself "Caucasian," you are not a person of color.
(8) If you said you weren't sure to either of the above questions, please explain more about your situation.
(9) How much money are you requesting? *
This amount should be between $100 and $500.
(10) What type of funding request is this? *
Required
(11) What do you plan to use the funds for, more specifically? *
(12) What other support, if any, can you access related to this specific need right now? *
(13) Have you ever received any other funds, grants, or scholarships in the past related to this area? If so, how much money did you receive? *
(14) If you receive funds from us, would we have permission to use your name online publicly? *
(15) If you receive funds from us, would we have permission to publicly share what the funds are for? *
We will need to share the category with the American Association of People with Disabilities staff, but we can do this without your name and without any other details.
(16) How would you describe your race and ethnicity? *
(17) Would any of the following describe you? *
You don't need to share if you prefer not to!
Required
(18) Where do you live? *
Please provide city/town, province/state, country
(19) How old are you? *
Please provide city/town, province/state, country
(20) Is someone helping you fill out this application? *
(21) What is the name and relationship of the person who is helping you? *
Please write "NA" if you are filling it out by yourself.
(22) Would you like to share anything else about yourself?
You can share more about your identities (marginalized or privileged), your current crisis, or anything else you'd like to share.
Submit
Never submit passwords through Google Forms.
reCAPTCHA
This form was created inside of Autistic Hoya. Report Abuse