You don’t have to carry it alone.

The Application

Apply for support

The application takes a few minutes. We review every submission personally.

Don't fill this out:

Contact

First & last name

Email

Phone

City & State

Shipping address — used only to send your package

Your children

How many children do you have?

Ages

Diaper, clothing and shoe sizes

If you have an infant, are you breastfeeding or using formula? Select… Breastfeeding Formula Both Not applicable

Your situation

Are you currently parenting without a partner? Select…YesNo

Do you have family, community or others who can help right now? Select…YesNoSometimes

What does your child need most right now?

Is there anything else you'd like us to know? (optional)

How did you hear about ALAYA?

Consent

I confirm the information above is accurate. I understand ALAYA will contact me for a short verification call. I consent to ALAYA storing my information confidentially. (Optional) I'm open to sharing my story. ALAYA will never publish my name, face, or details without asking first. (Optional) Send me occasional updates from ALAYA.

Submit

We protect every mother’s privacy. We never share a name, face, or identifying detail without her explicit permission. When a story or photo appears on our site, it is shared with her consent.