Cycles Journal Pay-It-Forward Assistance Request Form

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Email *

Hi! What's your name?

For reasons of wanting to serve marginalized folks first with our offers, Do you self-identify as a BIPOC?

Yes I am Black

Yes I am Indigenous

Yes I am a POC

Other:

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Do you identify as queer or as part of the LGBTQIA+ Community?

Yes

Other:

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Based on your financial situation, What kind of assistance are you in need of in order to obtain a Cycles Journal?

Need some help affording

Can't pay rent or afford necessities

Clear selection

What country are you located in?

United States

Canada

Mexico

European Union

Australia

Other:

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Why are you interested in using Cycles Journal?

Would you be interested in a journal with a slightly scratched, torn or bent cover - these are even more discounted than a perfect journal would be & the imperfections do not affect functionality.

Yes

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Anything else you'd like us to know or consider?

Thanks for your time <3 Please allow up to 3 weeks for a reply - Please add cyclesjournal@gmail.com to your receiving email's contact list so that you can ensure our response won't go to spam!

We appreciate your patience as we currently only have the capacity to check this form on the 1st & 3rd Monday of each month. We will reply as we can to let you know what we can offer you <3

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

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