Snohomish County COVID-19 Mutual Aid Volunteer Sign-Up Form

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We are a grass roots group united to help our neighbors during the COVID19 crisis, especially undocumented families, immigrant and refugee communities, the elderly, communities of color, our indigenous neighbors, LGBTQ+ folks, the poor, under-employed, or unemployed, those with disabilities/compromised immune systems, families of incarcerated or detained folks, and any other affected people.

We can provide the following forms of support:
Groceries, supplies, or medicines delivery;
Help with finding Snohomish, Washington state, and federal resources;
Conducting phone check-ins and outreach in special cases;
Transportation when possible;
Mental and emotional health support;
Housing referrals.

YOU CAN CONTACT US BY EMAIL: covid19mutualaidsnoco@gmail.com
Instagram: @snocomutualaid
or Facebook message: https://www.facebook.com/groups/142262693785689/

REQUEST AID HERE:
https://docs.google.com/forms/d/e/1FAIpQLSfUjYdpudvIUtD9J77oN0_Rwoi2jnxELlIXjVg3NHPuUXVong/viewform

In Google anmelden, um den Fortschritt zu speichern. Weitere Informationen

What is your name? *

Add your pronouns too if you want

What is your phone number? *

Please include area code

How do you prefer to be contacted? *please provide phone and email above* *

Phone call

Text

Pflichtfrage

Where are you located in Snohomish County? *

Please tell us what city/town/area you live in or nearest to :

Do you have access to a car or bike? Are you able to drive or cycle to deliver groceries or supplies? *

Yes

Can pair up with a driver

Sonstiges:

Are you 21+ with a valid ID?

Yes

Sonstiges:

Auswahl löschen

Are you comfortable picking up prescriptions? *

Yes

Sonstiges:

Do you agree to trust that each person making a request knows their own needs? Can you agree to make deliveries without judgement? * *

We will not ask anyone to buy or deliver anything illegal. If your answer is "Yes, except..." please select Other and list the specific supplies or groceries you are uncomfortable buying / delivering, or situations you aren't comfortable with.

Yes

Sonstiges:

What do you need to feel safe while providing deliveries?

Check all that apply

A buddy to do deliveries with

Help acquiring sanitizer, mask, antiviral wipes, etc.

Help knowing if you are contagious

Sonstiges:

Would you like to help pay for the supplies / groceries?

Yes I can pay for/donate the groceries/supplies I pick up.

Yes. I have the money to make the initial purchase & can donate some, but I may need reimbursement eventually.

No. I have the money to make the initial purchase, but I will need reimbursement.

No. I will need funds up front to purchase any groceries/supplies.

Sonstiges:

Auswahl löschen

Money transfer will be via Venmo or Paypal, does this work for you?

Check all that apply

Yes

Sonstiges:

Auswahl löschen

When are you available?

Check all that apply. You may also leave more specific day and time schedules in the "Other" write in box.

Mornings

Afternoons

Evenings

Weekends

Can you speak or translate any other language besides English?

We encourage our volunteers to start setting up their own neighborhood mutual aid pods. Would you like support in building your mutual aid pod?

Instructions on how to build your own mutual aid pod here: https://docs.google.com/document/d/1-QfMn1DE6ymhKZMpXN1LQvD6Sy_HSnnCK6gTO7ZLFrE/preview

Yes

Auswahl löschen

What other skills can you contribute?

Researching resources, collecting supplies, emotional support, social media, phone-calling, volunteer coordination, Facebook and email management, liaising with other groups, etc

Are there things you would like us to know? Any specifications, comments, or questions?

Any support or resources you would like to receive/offer, questions, comments, concerns.

Senden

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