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Corpus Christi Mutual Aid "Offer Support" Form
If you cannot fill out the form or do not feel comfortable sharing personal information, please contact us at (361)360-1869 or corpuschristimutualaid@gmail.
Lee la forma en español:
https://forms.gle/G3VyLas7NnefwgHn9
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* Indicates required question
Email
*
Your email
Contact information
Name & pronouns
*
Legal name not required
Your answer
Phone
*
Your answer
Phone (secondary/backup)
*
Your answer
How should we get a hold of you?
*
Email
Phone (text)
Phone (call)
Required
Zipcode
*
Your answer
Details about your offer for support
Do you agree to trust that each person making a request knows their own needs?
*
Yes
No
Are you 21+ with a valid ID?
*
Yes
No
What kind of support are you willing to provide?
*
Pay for someone's grocery box ($40)
Shop for someone's grocery box (get reimbursed $40)
Deliver someone's grocery box
Deliver multiple people's grocery boxes
Pay someone's bill (in full)
Emotional support/wellness checks
Other:
Required
What type of money transfer works for you?
Cash
Venmo
Paypal
Cash App
Clear selection
Username for money transfer app selected above:
Your answer
Generally, what times are you available?
You may also leave more specific day and time schedules in the "Other" write in box.
Mornings (Monday - Friday)
Afternoons (Monday - Friday)
Evenings (Monday - Friday)
Mornings (Saturday & Sunday)
Afternoons (Saturday & Sunday)
Evenings (Saturday & Sunday)
Other:
What languages do you speak?
Your answer
Do you have other skills you would be willing to provide?
Translations, household assistance, childcare, dog walking, pet-sitting, graphic design, research, social media, etc!
Your answer
Any additional specifications, comments, or questions?
Your answer
Send me a copy of my responses.
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