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Domestic Violence Assistance Form
Please contact us at theblackfairygodmother@gmail.com if you have questions prior to filling out this form.
13
Questions
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1
Name
First Name
Last Name
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2
Email
example@example.com
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3
What state are you located in?
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4
Are you aware the families we assist are marginalized?
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5
Are you aware there is a rise in domestic violence in marginalized communities?
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6
Are you aware many Domestic Violence shelters and hotlines are overwhelmed?
Bill could consist of housing, utilities, or educational assistance
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7
Are you willing to sponsor a individual or family who currently in a domestic situation?
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8
Are you comfortable with donating $250, $500, $1,000 or more to sponsor BFGM Purple Diamond awards for all the survivors/victims who need to relocate or start their lives over?
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9
Are you aware your contribution will help save the life of someone and their children by providing housing, employment, and education?
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10
Can you commit to $250 - $500 raising the funds to grant a few of our recipients at the gala in New York City on October 30, 2021 a new of life?
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11
Are you aware your contribution is tax deductible?
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12
Are you comfortable with making a post on Instagram, Twitter, And Facebook (not in your stories) about a family experiencing hardship and needing assistance?
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13
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*
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