Emergency Assistance Covid-19 Fund: Phase 2

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Through the grant provided by SisterReach, Love Doesn't Hurt is able to provide 50 Emergency Assistance Scholarships to members of the LGBTQ+ Community in Shelby County, Tennessee that have been victims or crime or have experienced previous trauma. Please answer the questions below to see if you are eligible.

Name: *

Preferred Name: *

Email *

Phone number *

Race *

African American/Black

Caucasian/White

Hispanic/Latinx

Native American

Other

Sexual Orientation *

Lesbian

Gay

Bisexual

Transgender

Queer

Plus

Other:

If you choose other, how would you describe your orientation?

Gender: *

Female

Male

Transgender

Non Binary

Other:

If you choose other, how would you describe your gender?

Have you been a victim of a crime? *

Yes

Have you experienced trauma? *

Yes

Briefly describe the crime or your trauma? *

Are you willing to complete intake paperwork? *

Yes

Are you willing to participate in a virtual intake to process your application? (phone, zoom, or google meet) *

Yes

Best time to contact you? *

Morning 8-11:30 a.m.

Afternoon 12-4 p.m.

Evening After 4 p.m.

Anytime

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