Items Request Form | Mask Bloc Naarm South East
Use this form to request items from Mask Bloc Naarm(Melbourne) South East. 
Items open for request include N95 and other high filtration masks, RATs, nasal spray, mouth wash... - open to suggestions. Check Instagram for updates on current availability.

We will reach out to confirm details before fulfilling every request. If you haven't heard back within a week, please email at maskbloc.melb.se@gmail.com.

If you have donation inquiries, would like to volunteer, or have any other general questions, please reach out via Instagram DM or email <3

Information safety: There is currently 1 person running this google account, and we(I) will delete the request and all personal information after it is fulfilled.

Thank you for your support!
-- @maskbloc.melb.se
Sign in to Google to save your progress. Learn more
How shoule we call you? (Preferred name and pronouns) *
Are you requesting for... *
Tell us what do you need (Items and amount)  *
If unsure of the amount, tell us how many people need masks/items, adult or children, & happy to discuss further
And any mask size and model (ear loop/head strap, etc) preference that you or the group have. 

Last update of what's available is on 29 Feb 2024 on instagram
When do you need the items by? *
Note: Please only anwser one of the pick up/delivery question below! *
If you would like to do pick up, please fill this question and we will contact you to discuss!
Select all that works for you.
Note: Not all items are available at all locations immediately.
We will reach out to determine the date/time of pick up.
If you need items to be delivered, please enter delivery address, and date/time preference
Delivery are made by volunteers, not via post. Choose delivery if you are ok with sharing a home address and a semi-flexible* delivery time for the volunteer.
How should we contact you? *
Instagram message/Email/Text are available methods!
Anything else we need to know? 
Access/security needs etc
(If you have feedback or suggestions, feel free to put them here or send an email/Instagram DM!)
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy
Google Forms