Wall Of Moms - Denver

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

This org came together very quickly, and we want to take a minute to assess your needs and limitations. This will not be shared with anyone beyond the admins. When you finish, you will be sent a link to download our Unofficial Protest Handbook for New Activists.

Email *

Have you participated in protests before?

Yes

Clear selection

Are you immunocompromised?

Yes, and I am unable to attend events right now.

Yes, and I still will not be able to attend events once COVID ends

Clear selection

Do you have physical limitations or disabilities? *

Yes

If you answered, "yes" above, please describe the accommodations you need.

Are you a member of other local community organizations?

Yes

Clear selection

If you answered, "yes" above, which orgs do you currently work or volunteer with?

If you want us to add you to our Signal chat for secure, on-site communications during direct action events, please enter your phone number below.

Are you interested in becoming a protest medic?

YES! I already work in the medical field!

YES! But I don't work in the medical field!

No thank you, but appreciate that we will have them!

Clear selection

Are you interested in joining our security team?

Yes, the virtual team

Yes, the on-site team

No thank you, but appreciate that we will have one!

Clear selection

Do you identify as BIPOC and have an interest in an admin role? If so, tell us how to reach out to you.

A copy of your responses will be emailed to the address you provided.

Submit

Clear form

Never submit passwords through Google Forms.

reCAPTCHA

Privacy Terms

This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy

Forms