JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
Funding available to resource Disabled, Neurodivergent and D/deaf Rebels engage with The Big One
Form filling can be a barrier for some. The Disabled Rebels Network is happy to advise and support if wanted. Email us at xr.inclusion@protonmail.com
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Email
*
Your email
Name
*
Your answer
Telephone Number
*
Your answer
Are you in an XR group?
*
Your answer
Amount you are applying for
*
Your answer
What is the money for?
*
Your answer
Is there a deadline you need to receive the funds by?
*
No there is no deadline
Yes there is a deadline
If you said there is a deadline what is that date please?
MM
/
DD
/
YYYY
Thank you for filling in the application. The next stage - someone will be in touch with you. What is the best way to contact you? (email/telephone/Mattermost/Signal/Whatsapp)
*
Your answer
GDPR:
What to expect:
If you wish to withdraw your consent and stop hearing from us, simply contact us at
steeringgroup@protonmail.com
We value and respect your personal data and privacy.
View our privacy policy
.
By submitting this form, you agree* that we may process your information in accordance with these terms.
*
* I agree
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google.
Report Abuse
-
Terms of Service
-
Privacy Policy
Forms