Join the Resistance!

Name?

Please provide a name that helps us check with your references.

What are your pronouns?

Email

example@example.com

Do you have your own transportation?

Yes No

Phone (Please use Signal)

Area Code Phone Number

Are you from the area?

Where are you coming from?

What dates/what is your timeline for being involved here?

Please list organizations you participate in.

Please list any skills you have or roles you can fill while at camp; eg direct action, jail support, media, hiking, camping, etc.

What experience do you have in the skills that you listed? Please be mindful of security.

Have you been called in to an accountability process? If so, for what? Can you give us a contact for someone on your accountability team. Having been called in does not mean we will not accept you to come to camp. Lying may.

How did you hear about Appalachians Against Pipelines? Do you know anyone involved?

Reference 1

Name, Phone Number, Years Known

Reference 2

Reference 3