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Join BRRN - Intake Form
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Alias
Pronouns
Email
Phone
Signal Username/Phone
Street
Zone
Legal Name (in case you are arrested. Optional.)
Emergency Contact Details
Groups you’re currently a part of / organizing work done
What do you do for work or school? Flexibility?
Why do you want to be involved?
Do you support the abolition of ICE?
Select...
Yes
No
Do you oppose racism, anti-immigrant sentiment, homophobia, and transphobia?
Select...
Yes
No
Thoughts on U.S. foreign policy or imperialism?
Skills / Roles You Can Play
Languages (read/write/speak + fluency)
Do you already know someone involved in organizing? Who?
Could someone vouch for you if needed?
Any concerns, limits, or safety needs?
Do you have a car?
Select...
Yes
No
Are you comfortable giving rides within your zone or nearby?
Select...
Yes
No
Have you ever been part of law enforcement or the military?
Select...
Yes
No
How did you hear about us?
Upload any supporting documents or photos
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