Surgical Masks for Seniors
Seniors (60+) May apply to receive surgical masks from WeCare.
WeCare Canada received a generous donation of Surgical Masks from Ranchlands Pharmacy with the intention of distributing them to seniors in the community.
If you are a senior or know a senior that might benefit from these masks, please fill this application.
One application per household.
The distribution will occur while quantities last.
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Full Name of Senior *
Full Name of Applicant
If you are applying on behalf of a senior
Address of Senior *
Date of Birth of Senior *
MM
/
DD
/
YYYY
Phone Number of Senior *
Spoken Language of Senior *
How many seniors reside with you? *
Are you able to pick up the masks? *
Pick up from WeCare Office in NE
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