Request support from Portage Park Mutual Aid
ESPANOL AQUI: https://forms.gle/j9RfCvVK7LXUGuWK9 

For two years, Portage Park Mutual Aid has existed as a volunteer network of neighbors helping neighbors. If you need help and live in the Portage Park area, let's connect.

We will try to reply to your response to this survey within 48 hours. We're so glad you've reached out to us for support and want you to know that you are cared about.
Conectează-te la Google ca să îți salvezi progresul. Află mai multe
Do you live in the Portage Park neighborhood of Chicago? *
Imagine fără legendă
What's your name? *
Your pronouns (ex: she/her, he/him, they/them)
If you want to learn more about pronouns, visit https://www.mypronouns.org/what-and-why
How should we contact you? *
Obligatoriu
Enter your phone number here:
Enter your email here
How many people are in your household?
What kind of assistance are you looking for? *
Obligatoriu
Can you share a bit more information about your situation?
Trimite
Golește formularul
Nu trimiteți parole prin formularele Google.
Acest conținut nu este nici creat, nici aprobat de Google. Raportează un abuz - Condiții de utilizare - Politica de confidențialitate
Formulare Google