Volunteer Intake Form
Name
*
Preferred pronouns
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Email
*
example@example.com
What days are you available to verify ICE reports in your area?
*
Mondays
Tuesdays
Wednesdays
Thursdays
Fridays
Saturdays
Sundays
None
What time of day are you available to verify ICE reports in your area?
*
Mornings
Afternoons
Evenings
Overnight
None
Are you currently employed and/or attending school? If so, please share where you work and/or take classes
Can you help share Know Your Rights info and the ICE Reporting Hotline?
*
Yes! I can pick up flyers and talk to my neighbors
Yes! I'm down to join a group to knock on doors
Yes! I'm down to pick up flyers and share with my personal network
Not at this time
Yes! I will share the Don't Open for ICE Instagram post @psliowa
Are you a part of any other organizations, faith groups, unions, or other personal networks that you can help tap into this work? (please explain)
How would you like to receive updates?
*
Telegram
Signal
Call or text
Email
Are you fluent in any other languages besides english? (please list)
Submit
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