This is a TEMPLATE of a form that was created to connect people with each other for mutual support. 

 

Do not fill this form out! Make a COPY of this form - Here's how: 
- First click the pencil icon in the lower right corner of the template.
- Then click the three dots setting icon in the top right side of the taskbar you see when you open the link below.

- Add this copy to your own Google Drive, then you can edit it as you like and share it with your neighborhood.

- You will be copying TWO PAGES, the FORM and the RESPONSES.

- You can create a Google Sheets spreadsheet from the RESPONSES page to make it easy for your neighborhood to view all of the responses in one place.

- We recommend that you adjust the sharing settings of your copy of this document so that anyone with the link can reply and see the responses. 

This is a Freesource offered to you by Rebecca Rockefeller, Beckah Lynn York, and Liesl Clark, in service to the international Buy Nothing movement. This template carries an Attribution-ShareAlike 4.0 International (CC BY-SA 4.0) license. You are free to copy and adapt. Click here for a link to the license.​ 

 

CLICK HERE FOR THE GOOGLE FORMS TEMPLATE - DO NOT FILL THIS OUT - MAKE A COPY FOR YOUR NEIGHBORHOOD AND SHARE YOUR COPY FOR YOUR NEIGHBORS TO FILL OUT

Below is the description at the top of the TEMPLATE:

This form was created to connect people with each other for mutual support.While we are observing social distancing, social isolation, and quarantine measures, we can still help each other safely. This form can help us do that, by bringing together those who need help with those who can offer help, and by setting up a buddy system in which people look out for each other through regular check-ins.

Here’s how to request help, offer help, and generally buddy up:

If you are looking for help of any sort, please fill this form out. Your information will be entered in a spreadsheet that others in our community can access in order to contact you if they can help.

If you can offer help of any sort, please fill this form out. Your information will be entered in a spreadsheet that others in our community can access in order to contact you when they need the help you can offer.

If you don’t need specific help at this time but would like to connect with a buddy to form a connection with a neighbor, so you can look out for each other, please fill this form out. Your information will be entered in a spreadsheet that others in the community can access in order to contact you to set up a buddy system connection.

Perhaps one of the most important things we can do right now for each other is to stay connected. We encourage everyone to activate that Buddy System we’re taught as children, to adopt a neighbor as your buddy and check in with your buddy each day via a safe method such as phone, email, text, and video chat. 

 

Important: This form and the attached spreadsheets are offered as a community service, meant to increase the public good. Everyone using this form and spreadsheets participates at their own risk. It is each person’s responsibility to follow public health recommendations, general personal practices, and their own research and risk analysis in order to participate in this buddy system. 

 

This is a Freesource offered to you by Rebecca Rockefeller, Beckah Lynn York, and Liesl Clark. This document carries an Attribution-ShareAlike 4.0 International (CC BY-SA 4.0) license. You are free to copy and adapt. Click here for a link to the license. ​

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