East Bay Disability Ally Form
Hello! Right now many disabled people (especially BIPOC - Black, Indigenous, People of Color) in the East Bay are needing extra support re COVID19. Caregivers are not able to come to work, immunocompromised people are not able to risk exposure to get groceries, hospitals may likely reach capacity, and in Italy, doctors are taking eugenic approaches to deciding who they save. Like many people, the Disability Justice Culture Club (a collective of disabled BIPOC organizers) are working hard to just to meet our own basic needs, but know that disabled and/or elder Black, Brown and people of color are most at risk of being harmed by COVID19, especially  physiologically and economically (many of us need to work in the gig economy). We know we are better together. We believe in people power and #NoBodyIsDisposable.

If you are a person with resources to offer, please complete the form below. We also gratefully accept donations via Venmo at @DJCultureClub. Funds will go to this project and mutual aid organizing.

If you are a disabled person with needs right now that aren’t being met with your immediate support system, please complete the form at https://tinyurl.com/DJCCsupportform. Please know that we are especially prioritizing BIPOC who need to limit exposure to others because of health concerns, and that we are organizing this as mostly-volunteers organizers. We may not be able to meet your needs, especially given that grocery stores are very low. We will reach out to everyone within 24 hours. If you are in a Berkeley, please contact Easy Does It Emergency Services at (510) 704-2111.
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Email *
Name *
Pronouns (ex. he/him, they/them, she/her, etc.) *
Phone Number *
Where are you located? Please list city and neighborhood as possible. *
How do you identify racially? Ex. White, Afrolatinx, etc. *
What languages are you able to speak? *
Do you have food (either groceries or cooked meals) you can offer? *
Required
Do you have paper towels, toilet paper, household supplies to offer? *
Are you fragrance free? (You can volunteer if you are not, we just have an extra need for frag free) *
Do you have hand sanitizer, 90% rubbing alcohol, or cleaning supplies to offer? *
Do you have time and a vehicle to run errands? If so what is your availability? (Days, nights, weekends, Tuesdays only, etc.) *
Are you open to going in someone’s home (likely with a partner) to help with laundry, light cleaning and other support? We are not offering personal care at this time. If yes, would you potentially have a friend willing to go with you? *
Do you have a disability or interact with a disabled person or elder? We strongly recommend you not sign up to run errands or home carework, we do not want you exposing yourself or loved ones at risk. *
Masks: Can you sew masks or help us source masks in some way? *
Required
If we raise funds, would you benefit from being reimbursed for what you spent? If you did carework in someone’s home, would you benefit from being paid for this work? *
Required
We are aware that our communities may not have the best experience with law enforcement. If the shelter in place becomes more enforced, do you have a problem doing runs knowing you may have to interact with the police? *
Is there anything else you'd like us to know?
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