PPE Mutual Aid Fund Application

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

Thank you for participating in the #MWAD22 PPE Mutual Aid Fund. If you are an on site museum worker impacted by COVID-19, apply here for a chance to receive 5 masks. We will confirm your submission via email.

***Only one submission is eligible for consideration. Duplicate entries will be deleted.***

Who is eligible? Any museum worker in the U.S. whose safety at work has been negatively impacted by the COVID-19 pandemic. PPE is intended for museum workers in vulnerable financial situations, even pre-crisis, including but not limited to the following:
- Front-line staff, janitorial, visitor services, security, retail, or cafe workers
- Part-time, temporary, and contract staff; freelancers
- Those living paycheck-to-paycheck
- Those who do not have generational wealth to lean on
- Interns (paid and unpaid)
- Those working fewer hours
- Caregivers of dependents

Your responses on optional questions will be anonymized and used for project documentation only. Your responses to these survey questions will help us document and share the experiences of museum workers impacted by COVID-19 and to support more museum workers like you.

If you have any questions, please email contact@nationalempnetwork.org.

First Name

Last Name *

Email address *

Phone number (we will only contact you if we can't reach you by email) *

Please share the best mailing address for you to receive your PPE below:

We will only be using this information to send you PPE. Please note that we will only be sending PPE to US-based addresses.

Street Address *

Please include apt/suite info as well! Ex. 123 Main Street, Apt 1

City. State, Zip Code *

We will only be using this information to send you PPE. Ex. New York, NY 10011

Which category best describes the museum(s) at which you were most recently or currently employed?

Art/Design Museum

Archive/Library

Encyclopedic Museum

History Museum

Historic House/Heritage Site

Maritime Museum

Military/War Museum

Natural History Museum

Science Museum

Zoo/Aquaria/Botany-based Museum/Living Collection (ex. Botanical Gardens)

Other:

With which area of museum practice do you most closely identify?

Administration

Collections

Conservation

Curatorial

Digital/Web/IT

Development

Education and Interpretation

Finance

Facilities

Marketing

Membership

Registrar

Social Media

Security

Shop Staff

Visitor Experience

Volunteer Management

Other:

At which museum(s) are you currently employed?

Which best describes your employment status right now?

Full Time

Part Time

Contract/Freelance

Volunteer

Other:

Clear selection

How long have you worked (paid or unpaid) in the museum field?

Less than 1 year

1-5 years

5-10 years

10-15 years

20+ years

Clear selection

What is your gender?

What is your age?

Are you Hispanic or Latino?

Yes

Clear selection

How would you describe yourself?

American Indian or Alaska Native

Asian

Black or African American

Latinx

Middle Eastern/Northern African

Native Hawaiian or Other Pacific Islander

White

Other:

Which degrees do you currently hold?

High school diploma or G.E.D.

BA (in progress)

MA (in progress)

Doctorate (in progress)

Doctorate

Other:

Clear selection

What is your household income?

Less than $20,000

$20,000-$34,999

$35,000 to $49,999

$50,000 to $74,999

$75,000 to $99,999

Over $100,000

Clear selection

How are you feeling about museums right now?

What do you think would be most supportive for museum workers right now?

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

Forms