Mountain Valley Mutual Aid Volunteer Intake
This intake form is for folks in Harrisonburg/Rockingham County and adjacent areas who would like to support community resilience through mutual aid. Please answer as thoroughly as you can and someone will follow up with you soon! MVMA came together to support hurricane relief efforts in Appalachia. We seek to provide rapid response to crisis, catastrophe, and chronic injustice so we can relieve intensity in the short-term while creating the mutual aid infrastructure that supports cooperative life for survival, resilience, and thriving for the long-term. As we practice solidarity as a form of direct action, we seek to make violent, exploitative systems obsolete as we put our own collective skills and capacities to work to enact the change we need rather than relying on representatives or authorities to do for us what we can do for ourselves.
Name
*
First Name
Last Name
Preferred Pronouns
*
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Signal username or contact number (we recommend you install this app if you don't have it already, as this is a primary means of communication outside of in-person meetings)
Location (city/county)
Volunteer Interests
*
Regional disaster relief (flood relief to Southwestern VA/Western NC)
Supporting immigrant communities
Supporting queer/trans communities
Prisoner support (letter writing/bail fund)
Fundraising
Supply drives
Childcare
Food sovereignty (food distribution and preservation, building/tending gardens, etc.)
Other
If you chose "other" above, please elaborate:
Are you fluent in any languages besides English (please list)?
Do you have access to a large-capacity vehicle (truck/van)?
Yes
No
Maybe
If applicable, please describe:
Do you have access to a facility that could be used for storage or gathering?
Yes
No
Maybe
If applicable, please describe:
Tell us about your availability (preferred days of the week, hours, etc.):
Please share anything else you'd like us to know about your volunteer interests, any special skills, access to resources, or share your questions or comments:
Submit
Should be Empty: