Individual or Family Application for Assistance

The Black Fairy Godmother Foundation (BFGM) is a 501(c)(3) nonprofit organization created to help black and brown marginalized families. We support women, families, and children in times of crisis by providing one-time grants of funds or goods. If you or someone you know could benefit from a grant from The Black Fairy Godmother, please complete the application below. All information will be kept confidential. If we are able to fund the application, we will be in touch.

The Black Fairy Godmother Foundation supports marginalized families and children by providing emergency assistance (excluding rental assistance, or purchase of a car). All information you submit is confidential unless you consent to us using anonymized information to share giving stories with our community.

Please note, BFGM provides emergency assistance only. We are unable to promote fundraisers and businesses at this time. BFGM does not help with legal expenses, car expenses, or evictions.

Please Note: Submitting an application does not guarantee funding.

Recipient Information

Full Name: (*)

Email Address: (*)

Street Address: (*)

Street Address 2:

City: (*)

State: (*)

ZIP Code: (*)

Phone: (*)

Social Media

We use this information solely for vetting the application.

Facebook URL:

Instagram Handle:

Twitter Handle:

LinkedIn URL:

Applicant Information

This section can be skipped if the Recipient is same as the Applicant.

Relationship to the Recipient:

Applicant Full Name:

Email Address:

Street Address:

City:

State:

ZIP Code:

Phone:

Tell Us About The Situation

Please provide a detailed description of the situation. (*)

A long story is not necessary, but details are helpful (i.e. employer's name, specific diagnoses, dates, links to articles, etc.)

Children's full names and ages (if any):

Please write a short paragraph explaining a proposed way for The Black Fairy Godmother to help. Please be as specific as possible, and list concrete things that would be of assistance to you. (*)

The Black Fairy Godmother provides grants of funds or goods only. We are unable to provide advice, provide connections with service providers, or promote fundraisers, products, or businesses.

What type(s) of assistance are you requesting?

Angel Food Assistance Program (groceries, medical, toiletries)

Domestic Violence Program (relocation and housing)

Fairy Dust Scholarship Program (tuition up to $5,000)

Emergency Angel Assistance Program (utilities and transportation up to $800 - no rental assistance)

Wishlist Angels Program

Supporting documentation must be provided at the end of this form.

If you need assistance with groceries, medical, and toiletries, please list the items that you need. (*)

Groceries are delivered via Instacart or Walmart.

Please include contact information for third-party persons familiar with the situation (we prefer websites with contact info for places of worship, schools (teachers), or service administrators):

Names and contact information for other organizations you have contacted to seek help for yourself or the applicant, whether currently or in the past. Please identify any online fundraisers (including links to such fundraisers), government grants/assistance, and/or other sources of assistance you have received to help with this need. (Please note that, having received other forms of assistance does not preclude you from receiving assistance from The Black Fairy Godmother. This information is used merely as part of our diligence process.)

The Black Fairy Godmother loves to share our giving stories with our community. Given sensitivities, we will often change names and limit details. Please select below if you do not want us to use pictures and your correspondence in sharing these stories. Please also check below if you would like us to anonymize your first name. We never use last names.

Correspondence

Pictures

Please anonymize our first names

How did you hear about The Black Fairy Godmother?

Documentation

Documentation is critical to our review process. Please provide a valid state-issued ID and documentation that supports your story and request. For example, if you are requesting support for medical needs, documentation may include proof of diagnosis and relevant bills. You can select and upload multiple files.

(*) Allowed file types: jpeg, png, pdf, and other image files.

By checking the box below, I confirm that I understand that submitting an application does not guarantee funding and that The Black Fairy Godmother Foundation will contact me if they can provide funding, services, or need additional information. This checkbox also acts as my electronic signature and confirms that all of the information submitted is truthful.

Confirmation and Electronic Signature

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