Rotary Assistance Request
We have recruited hundreds of volunteers in and around Groton to help people deal with the COVID outbreak. We are here to help with challenges large and small, especially for people who can not or should not leave their homes, either to protect themselves or to protect the community. Please use this form for any need you may have. Whether it is small or large, no matter where you live. Our resources are primarily in New London County and specifically near Groton, but we have a network of resources we may be able to refer you to.

We will do our best to get back to you as quickly as possible to find how we can best help.

If you have a life threatening emergency, please call 911. This is not for immediate emergencies of that nature.

We're all in this together!

-Michael Whitehouse
President Elect, Groton Rotary Club
Sign in to Google to save your progress. Learn more
Clear selection
Name
Phone
Email
Best method of contact
Clear selection
Address
Town (and state if outside Connecticut) *
Is this for you or someone you know?
Clear selection
Type of Need
Clear selection
Describe your situation
Specifically, what is needed to get through the next 2-4 weeks?
Are you (or the person we'll be helping) able to pay for the items which will be brought to you (so that we can have more for others in need)?
Clear selection
Once your immediate need is addressed, are you willing to help others if we can find tasks that you are able to perform?
Clear selection
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