Imperial Beach Personal Needs Request
Mayor Serge Dedina has created a task force in response to the COVID-19 pandemic. A cohort of individuals and organizations are here to help meet your needs during this challenging time. Please tell us what you need and we will work to find those resources. This is a work in progress, so it may take some time to get back with you.

Solicitud de Necesidades Personales: https://forms.gle/C8xoU9EFoS1pZP1U7

*Please do not give out personal information over the phone. Never share your social security number, bank accounts, debit or credit card number. Use caution when sharing your address.
Name *
Your answer
Phone Number *
Your answer
What is the easiest way to contact you? *
Required
Email address (if you have one)
Your answer
Do you have a personal need or would you like to volunteer? *
Required
What do you need right now? *
Required
How many people currently live in your household?
Your answer
We are partnering with local churches, if you are a member of a local church please let us know.
Your answer
Volunteer Pool
We are creating a volunteer pool so that when someone contacts us with a need, we have a list of people we can turn to for help. By adding yourself to this pool, you many not be needed right away but we will be in touch to discuss your interests or skills.
Volunteers: If you would like to volunteer, what interests you the most?
If you have completed a background check with a local organization, please list it below:
Your answer
If you are willing to volunteer, are you over the age of 18? If you are under 18, we will follow up with you shortly to discuss next steps.
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy