• Intake Form

    Protests Los Angeles : George Floyd Solidarity Protests
  • Instructions: Please fill out this form. Once you have completed the intake, review your answers before clicking submit.

    If you have any questions regarding the intake process, please reach out to Weston Rowland at rowlandweston@gmail.com

  •  -  -
    Pick a Date
  • Basic information (1 of 6)

  •  -  -
    Pick a Date
  • Information about arrest and citation (2 of 6)

  •  -  -
    Pick a Date
  •  -  -
    Pick a Date
  • Police crowd management (3 of 6)

  • Handcuffs and conditions of confinement (4 of 6)

    For purposes of this form, "handcuffs" includes both metal and plastic handcuffs (aka zip-ties or flexi-cuffs).
  • Until
  • Abuse by police and injuries (5 of 6)

  • Final questions (6 of 6)

  • Thank you for filling out the intake.

    If neccesary we will be in touch We are proud to support you and the other protesters. You’ll be hearing from us again soon.  If you have any questions about the intake process please contact Weston Rowland at rowlandweston@gmail.com

  • Feedback

  • Should be Empty: