COVID-19 Senior Support
We are looking to help Seniors 60+ and/or individuals with compromised immune systems during the COVID-19 Quarantine Period. Please sign up if you are willing to support this cause.
By submitting your name and contact information, you consent to SMC and other affiliate organizations to share your contact information to solicit help to those who need support during this COVID-19 Quarantine Period. Once your contact information is distributed it may not be retractable.
Which geographical area(s) are you able to service Seniors/Immunocompromised Individuals
Orange County: Northern Orange County (Anaheim/Fullerton/Buena Park)
Orange County: Southern Orange County (Irvine/Laguna)
Riverside: Temecula/Murrietta Valley
Los Angeles: San Fernando Valley
Los Angeles: Pasadena
Los Angeles: West LA
Los Angeles: Downtown LA
Los Angeles: Pomona/Diamond Bar
San Diego: Northern San Diego County
San Diego: Lakeside
San Diego: Downtown San Diego
San Bernardino: Ontario/Rancho Cucamonga
San Bernardino: Adelanto
Which Islamic Center are you most affiliated with
Send me a copy of my responses.
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google.
Terms of Service