I need help.

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

I need help.

This for is for those currently needing help, who are residents of the CKE neighborhood in Calgary, AB. The volunteers monitoring this form will match you with a volunteer helper 1:1, and get you help as fast/best as we can. Volunteers are members of Chinook Park Community Connections for Seniors and the CKE community generally.

Please check https://www.alberta.ca/coronavirus-info-for-albertans.aspx for updates on the state of emergency.

Your name *

Your phone number *

Your email *

Your address *

I need help: *

Getting groceries or other supplies like medicines

Shoveling my walk

Walking my dog

Other

Required

Please describe what you need further, including details about supplies or special instructions.

I am in self-imposed quarantine because I suspect COVID-19. (this question is asked for the safety of our volunteers)

Yes

Clear selection

I am in required quarantine because I am a confirmed COVID-19 case. (this question is asked for the safety of our volunteers)

Yes

Clear selection

Submit

Clear form

Never submit passwords through Google Forms.

This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy

Forms