Pride Month Giveaway Registration
Welcome! We're so happy you're here!

Please make sure to take a look at our requirements below before filling out this form.
Once we process all applicants, we will contact you if you have been accepted as one of our 30 recipients.

Here's a lil run down on how our giveaway works:
The first 30 eligible people to register will receive a month’s supply of groceries, a defense kit, a wellness kit, and if you'd like, a free binder delivered to your address! We will be distributing the groceries every Saturday beginning on June 5th until Saturday, June 26th.

If you have any questions, please email us at communityloving.org@gmail.com

****THIS IS FOR FOLXS IN SOUTH BAY LA - NOT THE BAY AREA UP NORTH*****

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Requirements
- Must be on the LGBTQIA+ spectrum
- Must be Black, Indigenous, or a person of color
- Do not have the means to purchase groceries, a binder, a defense kit, and a wellness kit
- Must reside in the South Bay area of ~Los Angeles~ (South Bay cities include Carson, Gardena, Hawthorne, Lawndale, Wilmington, San Pedro, Lomita, Harbor City, Harbor Gateway, Torrance, Inglewood, Compton, Los Angeles, and Long Beach)
Full Name or Alias *
Email *
Phone Number *
What is the best way to contact you? *
Age *
Instagram or Other Social Media Handle *
How do you identify? *
What is your race or ethnicity? *
Required
What are your pronouns? *
How would you describe your gender identity? *
Select as many as you need to describe yourself - If you don't find one that fits you, please specify your identity in "Other"
Required
How would you describe your sexuality? *
Select as many as you need to describe yourself - If you don't find one that fits you, please specify your identity in "Other"
Required
Street Address *
You must be in the South Bay area of Los Angeles to be eligible to receive a package. Please include your street address, including unit number (if it applies). Your home address will not be shared with anybody else outside of our team.
City *
Must reside in the South Bay area of ~Los Angeles~ (South Bay cities include Carson, Gardena, Hawthorne, Lawndale, Wilmington, San Pedro, Lomita, Harbor City, Harbor Gateway, Torrance, Inglewood, Compton, Los Angeles, and Long Beach)
State *
Zip Code *
By registering for this free giveaway, you understand that you will be receiving weekly deliveries of groceries every Saturday from June 5-June 26, 1 wellness kit, 1 defense kit, and an optional binder? *
You have the option to opt out of a binder below.
Do you have any dietary restrictions? *
i.e. vegan, vegetarian, allergic to nuts, prefer almond milk, etc...)
How would you like your items delivered? *
Would you like to opt out of receiving a binder? *
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