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Name

First NameLast Name

Email

example@example.com

Phone Number

Please enter a valid phone number.Format: (000) 000-0000.

State

County, if in Kentucky

Current opportunities I am interested in:

Possible future opportunities I am interested in:

Other

Tell us more: Why do you want to be involved with community defense and/or mutual aid in central Kentucky?

What language(s) do you speak fluently?

Where did you hear about this sign-up form / who referred you to our webpage?

If you use the Signal app, what is your Signal username, and/or what is your personal Signal link?

A Signal username starts with @ and ends with numbers. You can find this or your link in the settings of the Signal app.