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Royalton-Area COVID-19 Mutual Aid Survey
>>> Do you live in the Royalton area? Then this form is for you.

>>> Do you need help? Or someone you know? Then this form is for you.

>>> Would you like to volunteer or help support others? This form is also for you.

>>> Do you have a medical emergency? Please call 9-1-1.

This effort is being organized by Building A Local Economy (BALE) and Community Resilience Organizations (CROs) along with other local partners and in coordination with statewide organizers. We expect that COVID-19 will come to our communities, if it has not already, and we are coordinating a public response as a proactive and reactive measure to protect and support each other, particularly our most vulnerable populations. In this survey, we are gathering information about volunteer capacity, resources that can be donated and shared, local skills, and needs that people have.

A top priority at this time is to reduce the spread of the virus by staying home. Another top priority is making sure that all community members have what they need to enable each other to stay home, whether sick or healthy. Many actions to make this feasible will need to come into play. We'll also need to support each other in wider ways.

Efforts to determine needs are still in the development process, and coordination between many different groups is transpiring. We want to have a list ready to organize volunteer capacity as needs arise. We will not use or share the info you provide for any other purpose than COVID-19 organizing.

Thank you so much for looking out for others during a crisis that is reinforcing individualism. Safe distancing is important, but we also have to be able to support each other, even when we're physically apart. We must model community-level responses. We must love and care for one another.

Important: Noting that you would like to be contacted about any of the work mentioned below does not constitute a hard and fast commitment. We know circumstances can be unpredictable. Checking "yes" just means we may get in touch if needs arise.


Email address *
What's your name? *
Your answer
Is your community center in the Royalton-area? If so, please use this form! If not, please find a mutual aid form for your closest community. *
Your answer
Would you like to: *
Are you currently in quarantine or self-isolating and would like to request care? If so, please indicate your needs. *
Your answer
Would you like to be on a small team of volunteer coordinators? *
Would you like to be contacted about volunteer opportunities that involve being outside, such as distributing groceries or delivering food and leaving it outside the doors of people on quarantine? (Note: Risks and best practices will be discussed before any work is done. People over 50 and people with underlying conditions should be especially cautious in these times, so this option will not be right for anyone. Please do whatever you must to remain well.) *
Would you like to be contacted about volunteer opportunities that involve picking up donations, such as groceries, from stores or other businesses and transporting those materials to volunteers for distribution? *
Do you have any medical experience, including herbal support, that you may be able to offer to help boost our immune systems, or volunteer at pop-up clinics and testing facilities? *
Would you be interested in being part of peer-to-peer counseling via phone or online platform for those who are suffering from isolation or emotional crises? *
Would you be willing to share basic human needs like food, water, medical supplies, herbal medicine, hygiene products, shelter, etc.? Please indicate what you think you have to share. (It's ok if you don't know at the moment or if you don't have extra resources on hand.)
Your answer
Would you like to be on a team coordinating a specific volunteer activity? If yes, please explain your idea briefly.
Your answer
Could you offer someone any temporary work for people refraining from their typical jobs? (Remote, outdoor, etc.)
Your answer
Do you have special skills or particular resources you would like us to know about?
Your answer
Do you wish to be contacted about donations that are needed to support mutual aid work around COVID-19? *
Other thoughts or comments
Your answer
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