Maui County LGBTQ+ Assistance Network

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Amidst the impact of COVID-19 and current stay at home orders, please answer a few questions about how the LGBTQ+ members of the Aloha Maui Pride community can help each other. Your answers will be kept confidential and used only for this purpose, shared only with the AMP Board and our graphic designer.

Name *

Phone number

Preferred method of contact

Phone call

Text

Other:

Where in Maui County are you located? Aloha Maui Pride is committed to serving all of Maui County.

South Maui

Upcountry

West Maui

Central

North Shore

East Maui

Moloka'i

Lanai

Other:

Clear selection

How can Aloha Maui Pride help you? (Select all that apply)

Transportation

Deliveries (groceries, medication, etc)

Pre-made food

Non-prepared food (produce, canned goods, etc)

Financial assistance

Communication

Other:

How often would you need assistance?

Are you able to compensate for the assistance? ie paying for gas, delivered groceries, etc (this will not effect whether or not you receive assistance)

Yes

Partially

Other:

Clear selection

Is there anything you are able to offer your Aloha Maui Pride community? (Select all that apply)

Providing transportation

Shopping for others/making deliveries

Pre-made food

Financial contributions

Communication

Other:

How often would you be able to provide assistance?

Will you need compensation for the assistance provided? ie being paid for gas, delivered groceries, ingredients, etc (this will not effect whether or not you receive assistance)

Yes

Partially

Other:

Clear selection

What other ways would you like to see Aloha Maui Pride help our community through this time?

Do you know of other services we can connect with?

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