Benton County COVID-19 Request Form
Please use this form to request support.
OSU/Corvallis/Albany/nearby folks, are you self-quarantined, sick, immunocompromised, or similar? Do you need a way to take care of kids whose schools are closed? Are all the laundromats near your home closed?

These efforts are the work of the CGE Mutual Aid Caucus and the Benton County Family Response Team. CGE Mutual Aid Caucus is a group of graduate employees at Oregon State University and community allies dedicated to the building of community support networks and helping each other. Benton County Family Response Team is a group of local parents and activists that formed in response to the unprecedented community threat of COVID-19. We are coordinating together and with other local groups in the traditional homelands of the Kalapuya people, the living descendants of whom are members of Confederated Tribes of the Grand Ronde Community of Oregon (https://www.grandronde.org) and the Confederated Tribes of Siletz Indians (http://ctsi.nsn.us). 
Name *
Does not have to be your legal name
Pronouns *
Required
Phone number
Email address
Preferred contact method *
Household size *
So we know scope for food, laundry, etc.
What do you need? *
Please remember to practice good hygiene with any aid you receive. We're doing our best to everything clean, but this is a pandemic and please keep yourself safe!
Next
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy