Rockingham Help & Helpers-Sign Up

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This survey is to bring us all together to coordinate and organize a community response to COVID-19. We will all be affected, and we also want to make sure our most vulnerable neighbors are supported and safe.

TYPES of NEEDS: Folks may need help with food or prescription and that’s where this survey comes in. We want to build a team of volunteers that can support community members as the need arises. We will not use or share the info you provide for any other purpose than COVID-19 organizing in our local community.

VOLUNTEER: This survey will help us to know who and how you are able to help. By checking "yes" you agree your info will be added to our list of helpers, and we will help connect you with opportunities to help. We know things right now are changing daily, so if you are no longer able to volunteer please do let us know.

NEED HELP: We will do our best to find a neighbor who will be able to help. Don't be shy to list your needs (now and anticipated).

SURVEY BY PHONE: Folks can take the survey by phone (802) 463-4270. Let us know what you might need help with or how you can help.

SPREAD the WORD: Share on social media, reach out to your friends and neighbors, let them know we need their help, and know if they need help.

SAFETY: Everyone will be asked to follow the CDC COVID-19 Guidelines to keep everyone safe and healthy.

APRIL 3, 2020 UPDATE: If you signed up to volunteer before, please contact us if you're no longer able to volunteer. By phone: (802) 365-1324, email: deb@greaterfallsconnections.org. You may find you have needs you didn't have before, and if so feel free to fill out the survey again.

Thank you so much for your willingness to participate in caring for our community!
Rockingham Help & Helpers is a group made up of residents and organizations Our Place, Greater Falls Connections, Parks Place, Rockingham Free Public Library, Sustainable Rockingham, Rotary, Greater Rockingham Area Services, Fact TV, Great Falls Regional Chamber of Commerce with the support of Rockingham Emergency Management and the Town of Rockingham.

First Name *

Last Name *

Email Address

How would you like to be contacted? Phone? Cell? via Facebook ?

Where do you live? If you live somewhere else, consider starting a group in your community.

Bellows Falls

Saxtons River

Cambridgeport

Bartonsville

Brockaways Mills

Rockingham Meetinghouse area

Athens

Grafton

Westminster

Other:

Clear selection

What is your 911 Address? (Street Address, Town, State, Zipcode)

I or someone in my household is "High Risk" for Covid-19.

Check here

Do you need help or resources now or will you in the future?

Are you having trouble meeting your basic needs?

Food

Prescriptions

Childcare

Cleaning supplies

Toilet paper and hygiene supplies

Medical mask or other protection

Transportation

Someone to talk to

Someone to check on me or call me

Ideas to keep active

Taking care of my pets

Place to stay

Diapers

Other:

Do you have time and resources to give to our community?

How are you able to help?

Organize my neighborhood

Donate food

Deliver groceries

Make meals

Sew medical masks

Volunteer with food shelf

Make a donation of money (for the food shelf or other need identified by the Town)

Provide childcare

Drive someone to an essential appointment

Call someone who is feeling alone, isolated or scared

Help someone take care of their pets

Assist someone who is taking care of a loved one with medical needs

Help someone find a place to stay short-term

Other:

Are you willing to reach out to others who aren't able to fill-out this form online?

Yes

Other:

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Do you have any skills or resources you would like us to know about that might be helpful?

Do you have other thoughts or ideas that you think would be helpful for us to know?

By clicking here I give permission to share relevant information with people and organizations whom I can help or may be able to help me.

Check here

Are you considered an "Essential Employee?"

Yes

Submit

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