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Gas Assistance Requests

You can submit a request for gas assistance by completing the form below. Give Back a Smile provides all travel assistance digitally through Zelle so you can receive your assistance more quickly! Zelle is a digital payment service that is integrated with most banking institutions and is available through their app. You can learn more about Zelle and how to start accepting payments on their website (https://www.zellepay.com/get-started). Please contact your bank or Zelle regarding any questions about setting up your account. We are not able to provide assistance through alternate methods, including checks.

By submitting this form you agree to the Assistance Agreement

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