Emotional Support Stream - Relief Fund Application
Support from this initiative is intended for individuals directly impacted by the COVID-19 crisis. These funds and support are available to any individual on a first-come, first-serve basis, with the only limitation being how many funds we can raise. We are accepting donations indefinitely and hope to help as many people as possible affected by this crisis.

We also want to help by providing a platform to help artists in need with support to share and sell your work through the stream itself. If you would like to participate in this collaboration, please indicate your need on the form below and we will reach out to you.

This Google form serves as your official submission and places you in line to receive assistance. If you are having trouble submitting the form, try a different browser and ensure you are logged in under a valid email address. We cannot provide technical support for a Google form.

Recipients' names and identifying information will be kept private.
Email *
Your General Information
Please answer the following questions to the best of your ability.
Your Legal Name *
Date of Birth *
MM
/
DD
/
YYYY
Your Alternative Name
DJ name, rave name, nickname, etc.
Your Phone Number *
Your Facebook Profile *
Number of Dependents In Your Household *
Most Recent Employer Information
Please answer the following questions to the best of your ability.
Employer Name *
Business Address *
Business Phone Number *
Supervisor Name *
Covid-19 Impact Assessment
How has the COVID-19 crisis directly impacted you and your income? *
(Do not mention any sensitive information such as SSN, tax IDs, bank accounts, and so forth.)
If you're an artist interested in selling your work on the stream please leave a link to where your work can be found below.
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