Care Appalachia, Interest Form
Name
First Name
Last Name
Email
example@example.com
Phone Number
Please enter a valid phone number.
Organization (if applicable)
Are you...
A parent?
A caretaker?
An educator or school worker?
A social service provider?
Other
Please share how you currently experience or offer childcare in your community, including information about in the best case scenario, what elements would support you better.
Please indicate the ways the you'd be willing to support us.
"I'd like to participate in a focus group." We are offering paid opportunities for folks to participate in focus groups that will be designed to help us identify opportunities, issues, and needs as it relates to access to care in our communities.
"I'd like to work on designing solutions and organizing my community" We are working to convene a group of community leaders who will can devote time and capacity to this issue. This is the box to check you're willing to to devote a few hours a week to this work. Members of this working group will be compensated fairly for their contributions.
"I'm not sure yet, but this is important to me and I want to be involved!" We gotcha. We will keep in touch, and be sure to reach out as future opportunities emerge.
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