Shacklewell Covid 19 Providing Support
This form is for those looking to PROVIDE support.
If you are also looking to receive support, you can register your request here:
Sign in to Google
to save your progress.
Name we should call you
What is your full postcode?
Permission to use the contact details you provide.
Yes, volunteers from Shacklewell Covid-19 Mutual Aid Group can contact me via email or telephone
No, I do not not want to be contacted
What can you offer in terms of support?
Shopping & collecting prescriptions
Taking requests for help via the phone
Taking requests for help via email
Calling isolated people for a chat
Driving key workers to work
Fundraising and general hustle
IT support for isolated people
Linking up with other local organisations and companies
Please list any languages you speak
Pleas tick if you have any of the following:
Access to printing
Access to storage
Subscription to a pro online meeting platform
Are there any other personal skills or resources you have and might like to share / could be useful?
Rough outline of availability E.g weekend afternoons *should this be tick box or just written out?
weekdays during the day
weekdays during the evening
weekends during the day
weekends during the evening
Do you have reason to believe you may have had the virus? If so - Please give a date your symptoms stopped
What protective clothing do you have access to (if needed for your volunteering)
Gloves (latex or like)
A face mask (or like)
Do you have any other ideas for how you or your network might be able to support our community right now? ALL ideas welcome ;-)
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google.
Terms of Service