Birmingham Youth Here To Help

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Call 07952006537 if you need help filling this form.

This is Birmingham Youth doing their bit during Covid-19. Our volunteers are here to help you get through during these tough times.
This form has been created to help those in quarantine or self isolation to deal with all that comes with being home whether it is getting shopping or a friendly chat.

PLEASE ONLY USE THIS FORM IF YOU NEED HELP TO ALLOW OUR VOLUNTEERS TO HELP THOSE MOST IN NEED.

We cannot forget or abandon our most vulnerable
It is time we joined together globally to slow the spread of Covid-19.

Please fill out all the required fields in this so we can help you as best we can.

Name *

Phone number *

Please select request type *

A friendly phone call

Posting mail

Collect prescriptions

Food shopping for the essentials

List of shopping you require? *

Address *

Postcode *

Information about deliveries.

Please allow up to a full day for volunteers to pick up and deliver shopping or prescription to you. Everything is based on how easy it is to source the food and what is actually on shelves. We will phone you or send a text message to let you know if we need more time to deliver your supplies.

When do you need the shopping by? *

YYYY

How urgently do you need the shopping

Urgent (within one to two days)

Medium ( three to four days)

Low (within a week)

Further comments

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