Burch Ave COVID-19 Mutual Aid
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!
Sign in to Google to save your progress. Learn more
Name *
Phone *
Street address *
Block *
Number of residents *
Does anyone live here matching the following descriptions?
Other information we should know
Are you interested in supporting other neighbors during the COVID-19 pandemic? *
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.
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy