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Collect Mask Materials
Please provide the information below on your organization or place of business to collect materials for masks.
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Email
*
Your email
Organization Name
*
Your answer
Contact Person Name
*
Your answer
Contact Phone Number (include area code)
*
Your answer
Street Address (number and street name)
*
Your answer
City
*
Your answer
Zip Code
*
Your answer
County
*
Your answer
Do you have a covered space for bins?
*
Yes
No
Do you have 3 bins for cloth materials, vacuum bags, and masks, and a box for wire?
*
Yes
No
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