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COVID-19 "Offer Support" Volunteer Form for Chinatown International District
We are coordinating food and supply drop offs to residents in the CID neighborhood. Please use this form if you would like to help make deliveries. Thank you!!
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* Indicates required question
Email
*
Your email
Name, pronouns
*
Your answer
Organization (if any)
Your answer
What is the best way to contact you? (email, phone)
*
Please enter the product number
Your answer
What is your phone number?
*
Your answer
What is your email address?
Your answer
Do you have access to a vehicle?
Yes
No
Other:
Clear selection
If you do not have access to a vehicle, how far are you willing to walk from bus lines? Carrying how much weight?
Your answer
Do you need to be paid for your transportation or time?
Yes. I cannot do this work without compensation.
Yes. I can donate my time but I would like to be reimbursed for gas/bus fare.
No
Other:
Clear selection
Would you like to help pay for the groceries / supplies?
No. I will need money ahead of time in order to buy the groceries.
No. I have the money to make the initial purchase, but I will need reimbursement.
Yes. I have the money to make the initial purchase & can donate some, but I may need reimbursement eventually.
Yes. I will donate any groceries I pick up.
Other:
Clear selection
What type(s) of money transfer work for you?
Cash
Check
Venmo
Paypal
Other:
Are you comfortable picking up prescriptions?
*
Yes
No
Other:
Are you 21+ with a valid ID?
*
Yes
No
Do you agree to trust that each person making a request knows their own needs? Can you agree to make deliveries without judgement?
*
Yes
No
Other:
What city/neighborhood do you live in?
Your answer
What neighborhoods do you prefer to deliver to?
Chinatown International District
University District
Central District
Other:
Clear selection
Generally, what times are you available?
Mornings
Afternoons
Evenings
Weekends
Other:
What languages do you speak?
Your answer
Do you have any accessibility needs you want to share, or need anything else to feel safe providing deliveries?
A buddy to do deliveries with
Help acquiring hand sanitizer/wipes
Other:
Do you have other skills you would be willing to provide?
Your answer
Any additional specifications, comments, or questions?
Your answer
Thank you again for taking time to fill out a support form! We will contact you if and when we match you with a request. - InterIm CDA
This form is modeled from the inspiring work of COVID-19 Mutual Aid:
https://www.facebook.com/covid19mutualaid/
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