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Mutual Aid Group Facilitator Registration
Please provide the name of your Communal Section
*
Name
*
First Name
Last Name
Email
*
example@example.com
Phone Number
*
-
Area Code
Phone Number
Address
*
Street Address
Street Address Line 2
Department
Communal Section
Postal Code / Zip Code
Please tell us who you are, what kind of project your worked on previously, what do you hope to do as a Mutual Aid Group Facilitator in the Communal Section and why this work is needed in the communal section
*
Is your age less than 15 or greater than 64?
*
Yes
No
Do you have a paid job?
*
Yes
No
What is your highest level of education?
*
Do you own a computer with internet access or a smart phone with internet access?
*
Yes
No
Do you agree to verify and monitor that each mutual aid group member
*
provides 20 hours of work each week
takes 10 hours of training each week
keeps looking actively for job
keeps his or her children at school (if they have children)
practices the values of reciprocity, integrity, solidarity and respect
Do you agree
*
to provide 10 hours of training per week to group members
to arrange for the group members to receive 10 hours of training from local partners
to monitor on site the work of the mutual groups
to report weekly on their work and yours
to upload each week field videos showcasing the mutual aid groups work in the community
Do you reside in the Communal Section? (Residence in the communal section means that a person is living in the communal section: eating, sleeping and working and/or passing most of his time being physically there and the person is not a casual visitor or tourist.)
*
Yes
No
List the names, emails and phone numbers of 3 trustworthy persons (excluding yourself) residing in your Communal Section who can testify that you are indeed a resident of the Communal Section. Residence in the Communal Section means that a person is living in the communal section: eating, sleeping and working and/or passing most of his time being physically there and the person is not a casual visitor or tourist.
Rows
First Name
Last Name
Email
Phone Number
Person Number 1
Person Number 2
Person Number 3
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