Face Mask Interest

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Face Mask Interest

Easy Does It is collaborating with Whirlwind Wheelchairs to distribute FREE personal protective face masks to persons with disabilities who do not have access to such equipment. If you are interested in receiving a bag of 10 masks, please respond to the questions below. We will contact you to arrange to get the masks to you. The information below is required and will be shared with the donors of the masks.

Email *

Easy Does It Emergency Services

Are you a ... *

Please select one

person with a disability?

family member or friend of a person with a disability?

caregiver?

Other:

Can you arrange a time, during normal business hours, to pick up the masks (in Berkeley)? *

Yes

Maybe

Full Name *

Area Code and Phone Number *

Street Address *

(e.g. 1234 Any St.)

City, State, Zip Code *

(e.g. Berkeley, CA 94703)

A copy of your responses will be emailed to the address you provided.

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