Request for Runner Service
Please use this form to request shopping assistance from a volunteer runner. Once you have been connected with a runner, you will place an order at a store or pharmacy near you for the runner to pick up. They will pick up your order and deliver it to your doorstep. There should be no physical interaction between you and the runner (even if you really want to hug them—please don’t!). Runners do not expect tips or payment of any kind.
Sign in to Google to save your progress. Learn more
What is your name? *
What is your phone number? *
Can you receive texts at this number? *
Where should the delivery be dropped off? Please include street address and city. *
Please refer to the map below for the following question.
Which area (from the map above) do you live in? *
What store or pharmacy will the runner pick up items from? *
What is the preferred pickup/delivery time? Feel free to enter specific times (e.g., 2-4 pm) or a more general time (e.g., Thursday afternoon). *
Please be aware that, even though all precautions will be taken by the runners to sanitize and clean themselves, it is still possible to come into contact with the COVID-19 virus through this service. We hope that the risk is minimized by active protective measures, but we cannot guarantee that all steps in the process are sterile and free of the virus. Do you accept this risk? *
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. - Terms of Service - Privacy Policy

Does this form look suspicious? Report

Google Forms