Community Support Sign-up

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Thanks to the generosity of the City of Albuquerque, we were able to secure funding to provide COVID-19 response in the Black Community. We aim to use the funding to help both Black owned restaurants and the Black community.

This sign up sheet is for those who are suffering from food insecurities due to COVID-19 and to find out what other needs we can help with.

Questions? Email info@welstandfoundation.org

Email *

Please choose how you identify *

African-American

Hispanic

White

Native American / Indigenous

Asian

Other:

First and Last Name *

Phone Number

Address: This will be used to mail gift cards and or deliver supplies. Your information will not be shared with anyone else. If you are not comfortable giving you address, we have volunteers who can meet you.

Preferred Contact *

Phone Call

Text

E-mail

Community Segment *

Elderly or Immune System is Compromised

Family with Children over 5

Family with Children under 5

Single Parent Family

Low Income

Other:

Required

Please tell us about your need. (Examples include: help picking up medications, food need help finding childcare, need help picking up food items.) *

Helping picking up supplies, food or medication

Activities for children under 5

In need of a mask (homemade cloth)

Gift Card to Black owned restaurants

Other:

Required

A copy of your responses will be emailed to the address you provided.

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