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From our Classrooms to our Nurses: American Schools Care
Area schools that are able to donate disinfectant wipes. Please fill out this form after you have collected the wipes.
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School Name
*
Your answer
School Address
*
Your answer
School Zip Code
Your answer
School Phone Number
*
Your answer
Name of Contact Person at School
*
Your answer
Email of Contact Person at School
*
Your answer
Contact Person's Phone Number
*
Your answer
Name of Backup Contact Person
Your answer
Backup Contact Phone Number
Your answer
Number of SMALL containers (35 wipes per container)
*
Your answer
Number of LARGE containers (75 wipes per container)
*
Your answer
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