Shopping Day Needs Form

First name

Last name

Email

Yes, subscribe me to your newsletter.

Phone

These particular resources are designated for LGBTQI+ Newcomers: do you identify as part of that community?

Yes, I am a newcomer and I identify as part of the LGBTQI+ community

What types of items and goods are you hoping to take home from our "shopping" day experience? Check all that apply

How many people in your household?

Tell us more about yourself, your family, your holiday plans

What other support from UPlift Black would be helpful this time of year?

UPlift Black