You can always press Enter⏎ to continue
Emergency Assistance Adopt A Family Form
Please contact us at theblackfairygodmother@gmail.com if you have questions prior to filling out this form.
10
Questions
START
1
Name
First Name
Last Name
Previous
Next
Submit
Press
Enter
2
Email
example@example.com
Previous
Next
Submit
Press
Enter
3
What state are you located in?
Previous
Next
Submit
Press
Enter
4
Are you aware the families we assist are marginalized?
Previous
Next
Submit
Press
Enter
5
Are you comfortable with making a post on Instagram, Twitter, And Facebook (not in your stories) about a family experiencing hardship and needing assistance?
Previous
Next
Submit
Press
Enter
6
Are you comfortable helping a family pay an emergency bill? (i.e. rent, water, light, gas)
Rent maximum is $1000 / utility bill max $200
Previous
Next
Submit
Press
Enter
7
Would you like to donate to the fund OR to help pay a bill directly?
If you wish to pay directly please email our team at theblackfairygodmother@yahoo.com
Previous
Next
Submit
Press
Enter
8
Are you aware that you're responsible for making sure the contribution is fulfilled by sharing it on social media and encouraging family and friends to contribute?
Previous
Next
Submit
Press
Enter
9
If you choose to pay a bill, would you like for our team to send you a copy of the information?
Previous
Next
Submit
Press
Enter
10
Do you have any comments or questions?
*Please note any judgmental or abusive language towards the mother or foundation will be prohibited. If you are unable to fulfill the list or wish please communicate with us so that we are able to better assist you*
Huge
Large
Normal
Small
Ok
quote
Created with Sketch.
Ok
Previous
Next
Submit
Press
Enter
Should be Empty:
Question Label
1
of
10
See All
Go Back
Submit