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LGBTQ Legal Fund - Shenandoah LGBTQ Center
The Shenandoah LGBTQ Center is committed to improving the lives of LGBTQ people throughout the Shenandoah Valley. We know that queer people can become stuck in unhealthy cycles that keep them from thriving.
Our legal fund exists to help qualifying individuals with financial challenges as they navigate the justice system. Filling out this form is not a guarantee of assistance. We will reach out to you within a week to confirm receipt of your application and notify you of next steps.
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* Indicates required question
Email
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Your email
Full Name
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Your answer
Date of Birth
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MM
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DD
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YYYY
Physical address - where do you live? Please include residence number, street, city, state, and zip code.
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Your answer
What is your gender? (male, female, transgender, nonbinary, etc.)
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Your answer
What is your sexuality? (straight, gay, bisexual, etc)
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Your answer
Date of conviction
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MM
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DD
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YYYY
Optional: In your own words, what offense did you commit that led to your conviction?
Your answer
Name of your probation officer
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Your answer
What help are you seeking?
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Temporary help with court costs
Housing deposit
Inpatient detox (only if you are uninsured)
DMV license fees
Other:
Approximately how much do you need to cover these costs for one to three months?
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Your answer
What else would you like us to know?
Your answer
Please provide an email address and/or 10-digit phone number where we can reach you in regards to your application.
Your answer
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