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Oak Park Mutual Aid Request Form
Oak Park Mutual Aid is a coalition of neighbors based in Oak Park and surrounding communities dedicated to directly caring for neighbors in Oak Park, River Forest, Forest Park, Maywood, and the Austin neighborhood of Chicago. We aim to limit the impact of COVID-19 through our direct action, safely interacting with our neighbors to provide economic and social support. We want to help build a stronger community that will carry on past this crisis. We are what we create together.

If you need help, please complete and submit this form so that we can explore ways to assist you. We collect the minimum information that we need to safely and successfully fulfill your request. This information will be only be shared with the leadership team and specific volunteer(s) who directly respond to your request.  

We will do our best to contact you in a timely way and only through your preferred mode of contact. Given the number of requests our volunteer-only group receives, it may take a few days for us to respond.  In the case that we are unable to assist you directly, we will provide useful information and recommend other groups who may be able to better support you.

SAFETY FOR ALL
To protect both you and our volunteers, we will be following all CDC and social distancing guidelines for all pickups and deliveries, avoiding any direct person-to-person contact, wearing protective clothing, and practicing frequent hand-washing.

FOR MORE INFORMATION ABOUT LOCAL RESOURCES:
     > Oak Park "Quick Guide": https://bit.ly/opma-quick
     > Links to most common resource requests:  https://bit.ly/opma-common
     > Guide to resources by zip code:  https://healthconnectionhub.org/
     > City Bureau COVID Resource Finder: https://covid.citybureau.org/en/
     > Chicago 311 Service Request:  https://311.chicago.gov/s/?language=en_US



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Name (first only is okay) *
Phone Number *
Email address (to send relevant information)
Would you like to receive the newsletter that Oak Park Mutual Aid periodically emails out with updated resource information? *
Other contact info?
How should we contact you (check all that apply)?   *
Required
Are there any restrictions in contacting you (certain times of day, days of the week, etc.)?
Where do you live? *
If you are requesting assistance that may require someone to visit you at home, please provide your current home address.
Have you or anyone you now live with received assistance from Oak Park Mutual Aid before? *
Please describe briefly what kind of assistance you are seeking, and why. *
If you are requesting financial assistance, and we would be able to provide it, please share your electronic payment info (User ID for Venmo, PayPal, CashApp, or Zelle).  If you have none of these, please enter "None".
How did you find out about Oak Park Mutual Aid? *
Would you be interested in becoming a volunteer with Oak Park Mutual Aid to help us become neighbors providing true "mutual" aid? *
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