Free Binder Request Form
Welcome to UP & Away, Uniting Pride's Free Binder Program! This program is intended to serve residents of Champaign County, IL who 1) want a binder and 2) are not able to afford or safely purchase a binder on their own. WE ARE NOT ABLE TO DISTRIBUTE BINDERS TO PEOPLE LIVING OUTSIDE THE STATE OF ILLINOIS.

We are usually able to distribute binders to Illinois residents who live outside of Champaign County as long as they meet our other program requirements. If you are unsure if you qualify, please apply!

If you do not know your binder size and do not have access to a measuring tape, UP can provide you with one after we receive your application.

Please check the spreadsheet at the following link to view our current stock:

If you are requesting a binder size we have in stock, you should receive it within two weeks. If you are requesting a binder we do not have in stock, please allow us up to two months to coordinate a restock.

If you have not received an email response within two weeks of submitting your application, please reach out to for assistance.
Sign in to Google to save your progress. Learn more
What name may UP use when we reach out to you by email? If you prefer not to be referred to by name, you may leave this section blank.
What email address may UP use to contact you? *
What is your zip code? If you are not a resident of the U.S. state of Illinois, we will not be able to provide you with a free binder. *
Are you able to afford or safely purchase a binder on your own? (If your answer is "yes" but you feel that you would benefit from this program for another reason, please explain in "Other".) *
What is your gc2b binder size? (If you do not know and have access to a measuring tape or ruler, please use the following link: If you do not have access to a measuring tape, you may leave this section blank.)
What is your preferred gc2b color? (Please note that we cannot guarantee we will be able to get you a binder in this color. Also, please check for the names of gc2b nude shades. If you do not have a preference, you may leave this section blank.)
Which style(s) of binder are you interested in? Please check all that apply. (Visit to view gc2b styles. If you are not sure which style of binder will work best for you, please leave this section blank. We will discuss your options via email.)
Would you like to be sent information about how to properly wear and care for your binder? (If this will be your first time owning a binder, we strongly recommend you select "yes".) *
How did you find out about UP & Away? *
Did you know that UP offers support groups, a free food pantry, and help finding other resources? If you'd like more information about the other ways we might be able to support you, please confirm below or describe the help that you're looking for.
Is there any other information that you would like Uniting Pride to know before we reach out to you?
Clear form
Never submit passwords through Google Forms.
This form was created inside of Uniting Pride of Champaign County. Report Abuse