Assemblyman Schmitt Hand Sanitizer Request Form

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Assemblyman Schmitt Hand Sanitizer Request Form

Assemblyman Colin Schmitt is offering an allotment of NYS Clean hand sanitizer for reopening businesses and essential service providers in the 99th Assembly District. Supplies are limited and handled on a first come first serve basis while supplies last.

You will be contacted with pickup details which will occur in Washingtonville.

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Business Name *

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Industry *

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Contact Person *

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Email Address *

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Phone Number *

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