Peoria COVID-19 Mutual Aid Request Form
Complete this form, or call/text (815) 627-0716‬

While the national media is stressing individualism, and people are hoarding supplies, others see this as a time to lift each other up, and build new social structures that can exist without control from a government that has failed most of us, and corporations that only care about profits. We are prioritizing needs from traditionally marginalized people who have been left out, people of color, trans and queer folks, indigenous communities, the mentally ill, differently-abled people, un-documented people, sex workers, and inmates.

Identifying information in this form will NOT be shared with anyone other than aid-givers so they can help give you aid. We do not coordinate with ICE or law enforcement. We may share aggregate info about what community needs what.

Completing this form does not guarantee a that we can provide you with what you need. We are working to compile a judgement free list of what the people need and we will do our best to crowd-source resources to help us pull through this crisis together.
Email address *
Name *
Your answer
Phone Number
Your answer
What do you need? Please be as specific as possible (for example, if you need money, how much? If you need hygiene products, what specific type and how many?) *
Your answer
Check here to let us know that it is OK for us to contact you and to share your information with others who are trying to help. *
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