The Cupcake Girls | Oregon + SW Washington Support Request SUPPORT REQUEST: Oregon + SW Washington Branch Thank you for your interest in working with The Cupcake Girls’ Oregon + SW Washington Branch! We’re so thankful for the opportunity to assist you. If this is an emergency please dial 911. If you are involved in the sex industry or being affected by domestic sex trafficking, please fill out this support request form and a member of our team will contact you with next steps within 72 hours. * Your legal name is not required to make a support request* Hidden Fields Program Season ID Program ID Your Information Name + Location What is your first name? Does not have to be legal name What is your last name? Does not have to be legal name What are your pronouns? Ey/Em/EirHe/Him/HisPer/PersShe/Her/HersThey/Them/TheirsZe/Zim/ZirZie/HirOther City: What city are you located? State: Please select…ALAKAZARCACOCTDEDCFLGAHIIDILINIAKSKYLAMEMDMAMIMNMSMOMTNENVNHNJNMNYNCNDOHOKORPAPRRISCSDTNTXUTVTVIVAWAWVWIWYWhat state are you located in? Contact Information What is your phone number? Please ensure your phone number is entered correctly or your support request may be delayed. If you do not have a phone number, please put 000-000-0000. Is it ok to leave a voicemail at the phone number listed above? YesNo What is your email address? Please ensure your email address is typed correctly or your support request may be delayed. If you do not have an email address, please put none@gmail.com. Do you have any social media handles? (Optional) Twitter, Instagram Your Request Qualifiers What is your connection to the adult industry/sex work? CammingDancerEscortPornStreet Based Sex WorkTrafficking Survivor/VictimOtherSelect all that apply. Other connection to the industry: How did you find out about The Cupcake Girls? About Your Request What support are you looking for? (select all that apply) Career CoachingDental CareDiet/NutritionDomestic Violence ServicesEducation, Tutoring, GED, Higher EdFinancial AidFinancial Coaching + AdvisingGovernment Assistance + WelfareHealthcare/Medical ConcernsHousing: PermanentHousing: TemporaryInpatient ProgramsLegal ServicesLGBTQ+ ServicesLife CoachMental Health ServicesMentorship + AdvocacyParent/Child/Family ResourcesSubstance Abuse RecoverySuicide Awareness + ScreeningSupport GroupsTax AssistanceTrauma SupportOther Please provide any details you are comfortable sharing about your support request: PLEASE PRESS SUBMIT FOR YOUR REQUEST TO PROCESS. Contact Information