Request edit access
Santa Fe COVID-19 Mutual Aid Form
Times seem really wild and unpredictable right now and we can isolate and hoard or possibly find a way to stay in community and help each other out. Safe distancing is important, but so is solidarity.

Here's the idea: pair those in need in Santa Fe with those able to help by filling out this form. We'll do our best to match offers with requests.

This effort was launched by Raashan Ahmad/Beth Gutelius two community members who teamed up with organizers with Earth Care YUCCA/Red Nation/Santa Fe DSA/Fathers NM. The network now includes hundreds of volunteers including a hand-full of dedicated intake callers - who call every person who makes a submission so that we can connect you, our fellow community members, to all the resources we know of as well as the resources of the network.

This is a people-powered initiative by and for ALL people in our community regardless of race, creed, country of origin, immigration status, gender, sexuality, etc. We believe in the practice of solidarity and principles of equity and economic justice and are excited to be sharing and redistributing resources in this time of need.

If you have questions or suggestions contact us at santafemutualaid@gmail.com.

FIND THIS FORM IN SPANISH AT/Encuentre el formulario aqui: https://forms.gle/bZC6U8mHRhQ3irdT6

FIND A DAILY UPDATED LIST OF RESOURCES THAT MAY BE HELPFUL RIGHT NOW REGARDING FOOD, ECONOMIC ASSISTANCE, CHILDCARE, HOMESCHOOLING, ETC AT www.mutualista.org

*IF YOU ARE IN A RISK CATEGORY, PLEASE KEEP YOUR OWN SAFETY IN MIND IF OFFERING HELP*
First Name *
This does not need to be your legal name. You can also add your pronouncs if you want!
Last Name *
You can also add your pronouns if you want!
Email
Phone Number *
Address *
Do you have texting *
Are you offering a resource or requesting need?
Clear selection
If requesting a need, what are you requesting?
By when do you need this support?
If offering a resource, what are you offeing?
What is your availability to offer this support? (do you have scheduling constrainsts? certain days work better than others, frequency, etc)
Do you have specific professional skills you can donate to those in need at this time?
Further details regarding your need or offer *
Are you in a risk category? (immunocompromised, chroic condition including asthma, hypertension, diabetes, etc) *
Please share relevant information about your health condition *
Do any of the following apply to you? *
Please answer honestly. We will not ignore you on the your response to this, we just need to know so we can act accordinly.
Required
Help us organize! We need people to help connect offerings to needs *
We're looking for donations to support those in need in our community. Are you in a position to make a donation to support mutual aid work around COVID-19? *
What languages do you speak? *
Anything else?
Which neighborhood do you live in? *
Do you want to join a working group
Can you #shareyourcheck from federal stimulus bill with members of our community who will not qualify for federal aid due to immigration status, veteran status, etc? *
It is important that we are able to uniquely identify each member of the network - below we ask for your date of birth. This information is not shared with anyone but the intake team and it is used for identification purposes ONLY in order to track fund disbursements.
Date of Birth
MM
/
DD
/
YYYY
Have you been impacted by COVID-19? *
Have you been negatively impacted financially because of COVID-19? *
Have you lost wages because of COVID-19? *
Have you lost/reduced hours at work because of COVID-19? *
Are you unable to work due to childcare/family needs? *
Because COVID-19 crisis are you worried of losing housing or have lost housing? *
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy