Mutual Aid Application

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Thank you for your application!

Full Legal Name

Preferred Name

Pronouns

Phone Number and/or Signal Handle

How did you hear about us?

Explain your mutual aid request and include specific cost estimates. If there is a specific bill you’re requesting aid for, please provide it in the file upload section below. Where possible, funds will be paid directly to the owed party. If there are deadlines associated with this request, please provide. If this request is for someone other than the person filling out this form, please note here.

Drag and drop or click to select a file.

Have you submitted this request to any other organization (TCN, C.A.T., Trans Liberty, etc.)? If yes, please list.

The LGBTQ Foundation of Kansas may work with other organizations to allocate funds as needed. You can choose to opt in to allow your information to be shared with external entities solely for the purpose of fulfilling your request (we will never sell your data). This is to cut down on the number of forms you need to fill out and streamline mutual aid requests. By default, you are OPTED OUT of data sharing.

OPT IN

Once your application is received, it will go through an evaluation process that may take up to 3 weeks. Throughout this process, the LGBTQ Foundation of Kansas may request additional documentation, contact the recipient for clarification via the contact information provided, and/or request to schedule a video call with the recipient. Submission of this application does not guarantee distribution of mutual aid funds.

By submitting this form you are agreeing to our Terms and Conditions. Please review prior to submitting this application.