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MARJ - Mutual Aid & Restorative Justice
Please fill out this form to help us get a sense of what you need, what you can contribute, and which circles you might want to participate in.
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Email
*
Your email
Name
Your answer
What pronouns do you use? (Example: she/her, he/him, they/them, ze/zir, no pronouns, etc.)
Your answer
City & State
Your answer
Neighborhood Name
Your answer
Phone number
Your answer
What language do you prefer to use?
Your answer
What race do you identify with?
Your answer
Are you formerly incarcerated?
Yes
No
Clear selection
Do you want to be paired with someone to check-in with?
Yes
No
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If yes, how regularly do you want to check in?
Your answer
How do you want to check in? (Check all that apply.)
Text message
Phone call
Email
Video call (Skype, FaceTime, Zoom, etc.)
Other:
Are you interested in online check-in circles or wellness gatherings? Check all that apply to you. (If you have an idea for one, please let us know in "Other".)
General, open to everyone
For formerly incarcerated people
For survivors of intimate partner violence and sexual harm
Meditation and guided breathing session
Other:
When are you generally working/busy and when are you generally available?
Your answer
What are your hobbies and interests?
Your answer
How did you find out about us?
A friend told me
A social service or non-profit told me
I found it online
Other:
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