OAKLAND BIPOC SAFETY NETWORK SIGN-UP FORM
Oakland BIPOC Safety Network is a BIPOC + QTPOC led initiative to provide our community a first response safety network instead of calling in the systems built to oppress us.
Our goal is to create a first response care + safety network for Black and brown people prioritizing Black lives, Black safety, Black liberation from systems of oppression.
We are seeking volunteers + resources in these categories:
-MEDICAL SUPPORT (medics, emts, etc)
-MENTAL HEALTH SUPPORT (therapists, crisis counselors, de-escalation, mediators, after-care support,etc)
-SPIRITUAL SUPPORT (healers, holistic practitioners, etc)
-LEGAL SUPPORT (attorneys willing to provide pro-bono advice, counsel + representation if needed, etc)
-ACCOMPLICES (safe transportation for victims + support-providers, translators, etc)
-TRAININGS (de-escalation training, self-defense training, first aid training, etc)
Please fill out this form or email us at
to sign-up to be included in our network.
We will reach out with more information soon!
*REMINDER* We are currently creating a database of volunteers, accomplices, supporters and resources from which we can build our network. We will contact you and confirm participation before adding you into our finalized network! You will not be added to the network until we go through an intake process and confirm your availability, capacity and provide further training :)
Thank you for applying!
Phone Number (Via Signal)
Do you identify as LGBTQIA+? Please answer Yes/ No/ Decline to say/ Or if you prefer, please describe how you identify.
What ethnicities do you identify as ?
Where are you located?
Do you have a car ?
If you are located in Oakland/Bay Area: are you born & raised in Oakland/Bay Area ? / If NO, how long have you lived here? (brief explanation please)
What category/categories are you available to volunteer/ support in?
MEDICAL SUPPORT (EX: medics, emts, etc)
MENTAL HEALTH SUPPORT (EX: therapists, crisis counselors, de-escalation, mediators, after-care support) 2
SPIRITUAL SUPPORT (EX: healers, holistic practitioners)
LEGAL SUPPORT (EX: attorneys willing to provide pro-bono advice, counsel + representation if needed)
ACCOMPLICE (EX: safe transportation for victims + support-providers, translators)
TRAININGS (EX: de-escalation training, self-defense training, first aid training)
Please describe your area of experience and in what capacity you can offer support
Please provide your social media handle or a personal reference from the BIPOC community (please specify what you are including)
What is your availability like at this time?
On call 24/7 - any day, hour, would give notice before becoming unavailable
Flexible - Can be on call 4-6 days a week
Limited - Can be on call 1-3 days a week
Infrequent - Can be on call 1 day a week
Non-Urgent Consultation Only - Cannot be on call but can be available for non-urgent consultation
What days/times are you available?
Anything else you wish to share about your experience, availability, capacity? *REMINDER* We are currently creating a database of volunteers, accomplices, supporters and resources from which we can build our network. We will contact you and confirm participation before adding you into our finalized network! Thank you for applying
Send me a copy of my responses.
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