Face Shield Order Form
FRC Team 2052 KnightKrawler is 3D printing face shields for healthcare workers in partnership with the Mounds View Schools Education Foundation. For more information on this project and our team, please visit www.team2052.com. UPDATE: We no longer need plastic donations
Sign in to Google to save your progress. Learn more
Email *
Contact Name (First Last) *
Contact Phone Number *
Are you able to pick up your order from Chippewa Middle School in North Oaks, MN? *
Delivery Address (we prefer that you pick up if possible, but if you can't we will deliver to you)
Description of where shields will be used (e.g. ICU, general clinic, nursing home, etc.) *
Minimum number of shields you need *
Maximum number of shields (one per staff member please - shields can be disinfected and reused) *
Other comments
A copy of your responses will be emailed to the address you provided.
Submit
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
This form was created inside of KnightKrawler. Report Abuse