QNMA - OFFER of AID FORM

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Thank you for volunteering with QUINCY NEIGHBORS MUTUAL AID ! We show up for our neighbors and aim to connect people with localized mutual aid. You can help if different ways, but the overwhelming need right now is for food delivery (shopping and/or picking up groceries at the food pantry & dropping off in Quincy). You can get reimbursed by the QNMA fund when you shop. The information you submit in this form is only visible to 3 trusted organizers in Quincy.

IF YOU HAVE A NEED, PLEASE DO NOT FILL OUT THIS FORM. Instead, you can reach us by qnmaid@gmail.com or 617-237-0450.

Email *

What is your name & pronouns? *

How do you want people who need aid to contact you? *

Phone (call)

Phone (text)

Other:

Required

Phone #

Please check off what you can offer: *

Food Delivery (shopping and/or picking up groceries at the food pantry & dropping off in Quincy) You can get reimbursed by QNMA when you shop.

Conversation / companionship / check-in: PLEASE SPECIFY IF YOU CAN SPEAK SPANISH, PORTUGUESE OR HAITIAN CREOLE. Translators are needed and this can be done over the phone.

Petcare/dogwalking

Cooking

Cleaning supplies, gloves, etc.

Educational help / resources / tutoring

Internet subscriptions (share your netflix, prime, hbo, etc!)

Housecleaning

Other:

Required

Do you have access to a car / are you open to driving for pre-planned deliveries? *

Yes

Can you offer housing, short or long term? [tell us more in the following question]

Yes

Other:

Clear selection

* If you CAN offer housing please elaborate on capacity and other relevant info

Do you have capacity to help organize this network? We have several different kinds of roles to fill. *

Yes- follow up with me about what the network needs!

Yes but low capacity

Please feel free to express concerns, ideas, feelings, anxieties, etc. here:

Send me a copy of my responses.

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