We want to Support your Middle Schooler! Please fill out this form to request support for your middle schooler. If you have any questions, please feel free to e-mail Lovethybelly1@gmail.com General Info Parent Guardian Name * First Name Last Name Support Recipient's Name * First Name Last Name Parent/Guardian's Email Address * Phone * Country (###) ### #### My child is: * Black Queer Fat Additional Information Disbursement Methods Cashapp This account belongs to: The Guardian The Recipient Venmo This account belongs to: The Guardian The Recipient Zelle This account belongs to: The Guardian The Recipient I, the guardian, give Love Thy Belly express permission/consent to send my child the funds directly if I have provided their information above. * I do N/A I, the guardian, have completed this form out truthfully and accuretley to the best of my ability. * I have Thank you for your submission. We will work to get back to you as soon as possible but please allow us 2-3 business days. We look forward o helping your child recieve th care that they need and deserve!
