Support Offers - Mutual Aid Middle Border (MAMB)
Mutual Aid Middle Border serves the people of Caswell, NC, Danville, VA, and Pittsylvania, VA by connecting resources to those who need it most. This is a rapidly changing work in progress, and we are glad you are here.

By filling out this form, you are adding yourself and any supports/offerings that you can make to our neighbors. People will be able to see your name, email address (NOT your phone number), and what you can offer, and are invited to reach out to you directly for support.

Once you have met a need, let us know and we can cross you off of the offerings list. If you or someone you know has needs, please complete this form: https://forms.gle/bGZ7v2rXqE1E3U9NA

While the offers of support are people-to-people, the form and information are being managed by Middle Border Forward, a 501(c)(3) community organization. You can get more information about us by visiting https://www.middleborderforward.org/. You can ask questions at the end of this form, or by sending us a Facebook message: https://www.facebook.com/MiddleBorderForward/.
Sign in to Google to save your progress. Learn more
Email *
Name *
Don't want to use your phone number? Set up GoogleVoice!
GoogleVoice gives you a new phone number (you can choose your area code!) that works with your existing smartphone. Using the GoogleVoice app, you can send and receive text and calls. Recipients see your GoogleVoice number, not your regular phone number. Go to https://voice.google.com/about for more information and to get started.
Phone number? (will not be shared publicly unless you are a neighborhood point person, opt out available) *
Where in Danville, Caswell, or Pittsylvania do you live? (street name + city, will not be shared publicly) * *
Please check off what you can offer: *
Required
Are there any supplies or food that you could contribute to a communal pool? Please be specific in quantity. *
Can you communicate in languages other than English? *
Join our E-lists
List of Needs, Offers, Resources https://docs.google.com/spreadsheets/d/1j3C85C_kLfaknz-nI6ISELhZfVPWqDesR2dr7qgDxlw/edit#gid=2087944875
Please feel free to express any concerns, ideas, exclamations, feelings, anxieties, etc. here: *
A copy of your responses will be emailed to the address you provided.
Submit
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
PrivacyTerms
This form was created inside of Middle Border Forward. Report Abuse
Google Forms