Vermont Community Response and Mutual Aid Organization Entry Form
The Community Response Coordinating Team has come together to support the local mutual aid and community response efforts that have emerged in towns across Vermont. An editable and shared Google Sheet (https://docs.google.com/spreadsheets/d/1skVPLKPRlmW61g9GfzvAvpvkAIGLtHfIHFzOkQNxjaU/edit?usp=sharing) has been used to track and share the various informal groups and organizations that have been created locally across Vermont.  This new form has been created with the intention to transition from using the unwieldy common spreadsheet to a more manageable, better organized and comprehensive format. The data gathered from this form will be used for:
- a public-facing list of local organizations including local contacts
- a way for statewide and regional partners to share information with local groups
- gathering and sharing an overall sense of the impact of our collective efforts
Please take a few minutes to fill this out. Ideally this form will be completed once for each community where local organizing is taking place. Where there are multiple overlapping efforts, more than one submission is ok. The form looks long, but few of the questions are required. Fill out whatever is appropriate.  If you have any question, please feel free to contact nick@vtrural.org  Anyone needing direct assistance with their efforts is encouraged to fill out this form (https://forms.gle/4zFnYYYDpPxmPNtE6) and someone will follow up with you.
If you wish to see who has completed this form so far, check here for an updated spreadsheet - https://docs.google.com/spreadsheets/d/1fV3UVIuds9jtUy2ykJrDzVm9_-ruNa346Vl2vQLqOgg/edit?usp=sharing
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The following answers will be compiled for a public listing of local mutual aid and community response efforts
Please list the primary town you serve with your efforts
If you serve multiple towns, please list all of those towns (Please use this format: Marlboro, Halifax, Wilmington)
If you are coordinating with a regional effort, please list the name of that organization here
What count(ies) are you working in?
Please name a primary contact for your efforts (there is a section below to add other contacts)
Primary contact phone number (888-888-8888):
If your organization or effort has a name, what is it?
Please share a web link (URL) if you have any web presence.
Please share an additional web link (URL) if you have more than one web page (perhaps your volunteer and needs forms are separate)
If you have established a phone number or hotline where folks can call to request assistance, what is it?
Answers to the following questions will not be included in a public listing, but will help to best match resources with the mutual aid and community response groups working throughout Vermont.
If you are gathering volunteers as part of your efforts, how many volunteers do you have signed up?
Of those volunteers who have signed up, estimate how many have been active so far
What tasks have the organization and/or volunteers performed? (Check all applicable activities)
Is your organization coordinating efforts with your town/municipality?
Clear selection
Which of the following possible partners are you coordinating with, formally and informally?
Please list another contact within your organization to be included in ongoing communications.  
Name for contact #2 for your organization
Contact #2 E-mail Address
Contact #2 Phone Number
Do you want contact #2's information included in public listings?
Clear selection
Is there anything else you would like to share?
Submit
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