CT Mutual Aid Family Sponsorship
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Thank you for joining Mutual Aid! Sign up below to support a family throughout the pandemic with funding, food, and/or other supplies in your local area or statewide.
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Gracias por juntarse a Ayuda Mutua!
Email address *
Name // Nombre *
Phone Number // Número de teléfono *
Email address // Correo electrónico *
What are you able to support with? Please select one // Con qué puedes apoyar? Por favor, seleccione uno *
If, financial support only, how much are you able to contribute a week? // Solo con apoyo financiero, cuánto puede contribuir por semana?
Family Size you're able to support // Tamaño de familia que puedes soportar *
How far are you able to travel for delivery? // ¿Hasta dónde puede viajar para la entrega? *
Where are you located? *
Address, will be used for triaging only (Street, City, Neighborhood) // Dirección, se usará solo para triaging *
Are you also able to support with additional supplies as needed, if so, which ones? *
Required
Which languages do you speak? // Que idiomas hablas? *
Additional Comments // Comentarios adicionales
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