JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
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:
https://docs.google.com/forms/d/e/1FAIpQLSfJvn6txePuo0BxSKv9Rx9taHacn__6-tyqX-v3dN4SfgxePw/viewform
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Name we should call you
*
Your answer
Email address
*
Your answer
What is your full postcode?
*
Your answer
Phone number
*
Your answer
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
PROVIDING SUPPORT
What can you offer in terms of support?
*
Leafleting
Shopping & collecting prescriptions
Online/Admin tasks
Copywriting
Taking requests for help via the phone
Taking requests for help via email
Calling isolated people for a chat
Co-ordinating volunteers
Driving key workers to work
Fundraising and general hustle
IT support for isolated people
Linking up with other local organisations and companies
Other:
Required
Please list any languages you speak
Your answer
Pleas tick if you have any of the following:
DBS check
Bike
Car
Access to printing
Access to storage
Subscription to a pro online meeting platform
Other:
Are there any other personal skills or resources you have and might like to share / could be useful?
Your answer
Availability
*
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
Other:
Required
Do you have reason to believe you may have had the virus? If so - Please give a date your symptoms stopped
*
Your answer
What protective clothing do you have access to (if needed for your volunteering)
Gloves (latex or like)
A face mask (or like)
Hand gel
Other:
Do you have any other ideas for how you or your network might be able to support our community right now? ALL ideas welcome ;-)
Your answer
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google.
Report Abuse
-
Terms of Service
-
Privacy Policy
Forms
