Brooklyn neighborhood support network
We know that the COVID-19 coronavirus outbreak is presenting many challenges for the neighborhood. Brooklyn is organizing a neighborhood mutual support network to help fill those needs. We want to connect neighbors who can help those who need to shelter at home because they are at high risk from the virus. We also want to share information about supporting neighborhood businesses. All answers are private, only for use by Brooklyn Action Corps neighborhood association (BAC) and by volunteers on a need-to-know basis. You can also email us at or call (971) 222-9454.
First and Last Name (Optional: Significant Other's name too) *
Address *
Email *
Other contact info
Phone, alternate email, or other
Do you need support, or can you offer help?
Clear selection
What kind of support do you need?
Example: Delivery of essential supplies like food or prescriptions
What kind of help can you offer?
Do you have a vehicle for deliveries?
Anything that can transport supplies: car, van, truck, or cargo bike
Clear selection
Are you a medical professional or an emergency services/first responder professional?
If so, please briefly describe your role/experience
If you own or work at a Brooklyn neighborhood business, how can people support it?
Provide any details that the neighborhood should know, like if you have modified hours, pickup/delivery options, social media for updates, etc.
Anything else we should know?
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy