RadLAM COVID19 Emergency Relief Fund Application
Greetings Community

We know these are difficult and uncertain times and that many of us are wondering how to make ends meet and how to contribute. The crew of the Radical Libraries, Archives, and Museums network gathering are reaching out to raise funds to support those information, memory, and culture workers who aren't working or who have lost wages due to the COVID19 crisis. We would like to use our RadLAM funds, previously raised for an in-person Network Gathering at Allied Media Conference 2020, as seed money for a mutual aid fund for the library, archive, museum workers, storytellers, oral historians, and folks in the overall literacy community by continuing our fundraising efforts for that purpose. We will be prioritizing funds for QTBIPOC, disabled and chronically ill folks, and folks with urgent needs.

Sign in to Google to save your progress. Learn more
Name *
Location (City, State)
Email
Phone
What is the best way to reach you? *
How much financial support are you seeking? (We are aiming to support requests between $1-$600) *
Please describe how the COVID-19 outbreak has disrupted your income. (Please convey as much info as you feel comfortable disclosing) *
What expenses do you need support to cover and when are they due by? (Please convey as much info as you feel comfortable sharing. We would like to resolve the needs according to urgency).
Do you have any other sources of income that you can depend on in the next 30 days? (If yes, please include as many details as you can) *
Do you identify as part of the Queer and/or Transgender Black, Indigenous, or Person of Color community (QTBIPOC)? *
Are you disabled or chronically ill? *
Is there anything else we can be supportive of or any other resources we can connect you to? Please feel free to let us know.
Thank you for completing this application. We will follow up as soon as possible. We are sending you all our wishes for health and safety during this time.
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
Google Forms