Burch Ave COVID-19 Mutual Aid

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Burch Avenue is mobilizing our resources and people power to prepare to support our neighbors in case of disruptions to daily life caused by the Coronavirus. We are collecting information about our neighborhood so that we can support everyone. Your information will be kept confidential and shared only with trusted people within the neighborhood for the purpose of organizing our community's COVID-19 response.

Hispanohablante - haz click aquí: https://forms.gle/HkZoyjt6umasTfkL8

Solidarity! ¡Solidaridad!

Name *

Phone *

Street address *

Block *

Number of residents *

Does anyone live here matching the following descriptions?

Immuno-compromised (underlying health conditions such as diabetes or asthma)

Age 50-70

Age 70+

Working parent with children

Insecure financial situation

Healthcare worker / critical infrastructure worker

Person with disabilities

Person who doesn't speak English - note preferred language under "Other..." box

Other:

Other information we should know

Are you interested in supporting other neighbors during the COVID-19 pandemic? *

Yes

Would you like to be added to the Burch Avenue Neighborhood Association email list? *

You will still be part of the COVID-19 response network even if you don't want to be on the email list.

Yes

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