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Please Submit Only One (1) Application.

Birthday
Día
Mes
Año

Please upload an image of a valid, government issued, photo ID. **DAWA does not share any personal information to external parties under any circumstances

Have you previously received funds from the DAWA Fund?
No
Yes (Enter the Year)
Race
Gender
Preferred Pronouns
She / Her / Hers
He / Him / His
Ze / Hir / Hirs
They / Them / Theirs
Other
What are you looking for support with?
Current Household Income
Under $10,000
$20,000 - $29,000
$30,000 - $39,000
$40,000 - $60,000
Other
Preferred Method for Grant Deposit
Direct Bank Deposit
Digital Mastercard Gift Card
Rate Your Financial Situation
Okay
Bad
Very Bad
Crisis
Would you be interested in volunteering for a feedback interview?
Yes
No
Do you identify as a person with a disability? (Optional)
Yes
No
Do you identify as a person in the LGBTQIA+ community? (Optional)
Yes
No
Are you currently unhoused or facing challenges with housing stability? (Optional)
Yes
No

DAWA does not share any personal information to external parties under any circumstances.

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