Marceline Community Needs & Support

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Please take a few moments to let us know:
- What you might need during the Covid-19 situation
- How you might be able to volunteer to help.
- If you or someone you know could use a phone call to make sure they're doing okay.

We will keep your responses confidential, and they'll be used to help us figure out what additional resources might need to be developed, and what other ways we can help during this time. Thank you for your help.

We'll be collecting this information from Thursday morning (3/19) through Saturday (3/21).

Sincerely,
City of Marceline, Marceline Schools, Coordinated Welfare Council, Ministerial Alliance

What do you, or will you need? (check all that apply)

As many of us are staying home, or simply not able to get out, please check all of the boxes for things that you might need help with. These are things either you can't do for yourself, or don't have access to. If you need something that isn't listed, please check the "Other" box and write it in.

Having enough basic food items (groceries)

Prepared meals like a sack lunch or take out dinner

Non-food items like paper towels or toilet paper

Help with getting groceries or other supplies

Help with picking up medications

Transportation to doctor appointments

Knowing who to contact with questions

Other:

I Can Volunteer

If you are able to volunteer, please fill out the next set of questions. We will need help from many others to make sure we're meeting our community's needs.

Name

Phone Number

Can you receive text messages

Yes

Clear selection

Volunteer Work I Can Do

Please check all that you are willing to do. If you have another skill that you think is helpful, please check the "Other" box and let us know what it is.

Answer Phones/Call Others

Make Deliveries (with your own vehicle)

Organize and Pack Supplies

Carry Boxes

Shop for someone who can't get out

Other:

Checking On Others

If you know or someone you know could benefit from a phone call while we are going through this situation, please answer the following questions. If you are filling this out in regards to someone else, please give us your name, phone number, and email as well.

Name of person answering this question

Phone Number

Can you receive text messages

Yes

Clear selection

Name of Person(s) to Check On

Please put the person's name and phone number on the same line. If you entering multiple people, please put each person on a different line.

Submit

Clear form

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