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Needs Form for Neighbors Affected by COVID-19: Garfield Park
This form is for residents of the Garfield Park community to request assistance from fellow neighbors in Garfield Park.

Please fill out this form and we will do our best to match you with someone who could meet your need.

*This form is managed by the Garfield Park Community Council and was created on March 30, 2020 and updated on April 9th*
Email address *
Your Name *
Mobile Phone Number *
Where are you located? (To locally match you with someone who can help) Include address if able. *
Required
Street Address *
What kinds of items are you in need of?
Are you able to pick these items up from the Garfield Park Area?
Clear selection
What is your age? *
Required
Do have a COVID-19 related rent/mortgage issue that you would like to discuss?
Clear selection
Questions/Comments/Suggestions?
By submitting this form you consent to have your information shared with a volunteer to help meet your need. *
Submit
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