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Phone number *
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Address *
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Street(s) that you would be willing to cover
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Would you be happy to be a co-ordinator for a small area of the village?
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Do you consent to your details being stored until the conclusion of this effort? Your details will be stored securely, and only used in connection with the effort to help those needing help while the COVID-19 situation persists. Once this effort is no longer needed, all details collected using this form will be deleted. You can withdraw your consent at any time by emailing: *
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If you become symptomatic of COVID-19, or are required to self-isolate, you must immediately stop all help efforts that involve any form of personal contact *
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