MARJ - Mutual Aid & Restorative Justice
Please fill out this form to help us get a sense of what you need, what you can contribute, and which circles you might want to participate in.
Sign in to Google to save your progress. Learn more
Email *
What pronouns do you use? (Example: she/her, he/him, they/them, ze/zir, no pronouns, etc.)
City & State
Neighborhood Name
Phone number
What language do you prefer to use?
What race do you identify with?
Are you formerly incarcerated?
Clear selection
Do you want to be paired with someone to check-in with?
Clear selection
If yes, how regularly do you want to check in?
How do you want to check in? (Check all that apply.)
Are you interested in online check-in circles or wellness gatherings? Check all that apply to you. (If you have an idea for one, please let us know in "Other".)
When are you generally working/busy and when are you generally available?
What are your hobbies and interests?
How did you find out about us?
Clear selection
Clear form
Never submit passwords through Google Forms.
This form was created inside of The Ahimsa Collective. Report Abuse