LAKE ERIE MUTUAL AID & COMMUNITY DEVELOPMENT FOUNDATION
LEMA
Community Participation & Operational Intake Application
501(c)(3) Nonprofit • Erie County, Ohio • EIN 41-3078839
1. OPENING STATEMENT
The Lake Erie Mutual Aid & Community Development Foundation (LEMA) is a community development and stewardship organization focused on education, workforce activation, mutual aid coordination, infrastructure support, land stewardship, and productive community development initiatives. This intake form assists with participation coordination, workforce mapping, training opportunities, volunteer placement, and community development initiatives. Please note: Submission of this form does not guarantee employment, project placement, financial assistance, certification, or operational assignment.
2. PARTICIPANT INFORMATION
Full Legal Name
Preferred Name
Date of Birth
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Phone Number
Format: (000) 000-0000.
Email Address
example@example.com
City / State
Emergency Contact
Valid Driver's License
Reliable Transportation
3. OPERATIONAL AREAS OF INTEREST
Select all areas that apply.
Workforce Development
Construction & Site Preparation
Skilled Trades
Administrative Support
Drainage & Land Stewardship
Research & Documentation
Agriculture & Food Systems
Education & Training
Transportation & Logistics
Media / Communications
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Community Mutual Aid
Renewable Energy / Solar
Community Outreach
Cooperative Enterprise
Other:
4. SKILLS & EXPERIENCE
Transportation Barriers
Employment Barriers
Interest in Training / Certification
Housing Instability
Current Occupation
Previous Experience
Trade / Technical Skills
Equipment Experience
Agricultural Experience
Administrative Experience
Certifications / Licenses / Degree(s)
Languages Spoken
5. AVAILABILITY & PARTICIPATION
I am available for: (select all that apply)
Volunteer Projects
Paid Work Opportunities
Training Programs
Seasonal Work
Weekend Projects
Administrative Support
Emergency Mutual Aid
Community Events
LEMA Community Participation & Operational Intake Application
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Days Available
Hours Available
Preferred Project Types
6. NEEDS & BARRIERS ASSESSMENT
Access to Tools / Equipment
Internet / Computer Access
7. STEWARDSHIP & CONDUCT ACKNOWLEDGMENT
Participants are expected to uphold honesty, lawful conduct, safety standards, mutual respect, responsible stewardship, and professionalism during all organizational activities and projects.
LEMA reserves the right to limit or deny participation in cases involving misconduct, unsafe behavior, exploitation, threats, unlawful conduct, or actions harmful to project operations or community safety.
8. SIGNATURE & AFFIRMATION
"I affirm that the information provided is accurate to the best of my knowledge."
Signature
Date
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
FOR LEMA OFFICE USE ONLY
Date Received
Reviewed By
Placement / Notes
LEMA Community Participation & Operational Intake Application
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