Lakewood Mutual Aid Cash Grant
This form is for Lakewood neighbors (Lakewood Park, Lyon Park, and Tuscaloosa-Lakewood neighborhoods) experiencing hard times because of COVID-19/life. The Lakewood Mutual Aid network hopes to raise $4,000 in the next few weeks to give out $200 cash grants to neighbors to use as they need it.

If requests exceed donations, the network will prioritize Lakewood neighbors within the current mutual aid network that are unemployed/not eligible for state/local help/in need of medical assistance/ those with kids/senior citizens.

Please fill out the form by August 1st, 2020. Funds will be distributed by August 15th, 2020. Families will be notified if any changes occur.

There is a small group of neighbors through the Lakewood Mutual Aid network that will have access to this information and will be doing private follow up.

We'll also share when donations are dispersed, but will not share any personal information of donors or grant recipients.

If you have any questions, please contact lakewoodresponse@gmail.com or text/call ‪(919) 351-9926‬

INFORMATION WILL NOT BE SHARED WITH ANY GOVERNMENT ORGANIZATIONS OR SHARED PUBLICLY OUTSIDE A SMALL GROUP OF LAKEWOOD NEIGHBORS HELPING WITH SELECTION, DISPERSEMENT, AND FOLLOW UP.
Email address *
Name *
Please enter your name First Last
Language
What language do you mainly speak at home?
Clear selection
Preferred Contact
How should we contact you?
Clear selection
Phone
Please enter the best number to reach you at
Next
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy