Request PPE (The Humble Makers)

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This is a collaborative project managed by The Humble Makers with input and effort from fellow makers in the community. Please fill out this form to request PPE.

Due to overwhelming demand, we are currently only accepting requests from healthcare professionals and essential workers in the Houston area. We are not able to ship these items at this time.

To contribute your time to this project, please contact Ken at ken@thehumblemakers.org.

(http://thehumblemakers.org/)

Email *

First Name *

Last Name *

Phone Number *

Requesting # of Face Shields? *

Requesting # of Ear Strain Relief Clips? *

Type of Facility *

Hospital

Other Healthcare Facility

Paramedic

Law Enforcement

Fire Department

Nursing Home

Essential Retail (grocery store, pharmacy, etc.)

Other:

Facility Name *

Facility Street Address *

Facility City *

Facility State *

Facility Zipcode *

If needed, are you able to show proof of ID (Work Badge, LinkedIN, etc.)?

Will you be able to pickup the requested items from our facility in NE Houston? *

Yes

Other:

Will you agree to do your best to send a picture to our group when you receive the donation? Pictures play a vital role for the volunteers, they truly love to see where all their hard work is going! We will not use your picture without your consent. *

I agree

Can we utilize pictures you provide in our social media updates? We would love to let our community see where all of these donations are being put to good use! Please note that opting out of this does not eliminate you for receiving PPE materials. *

Yes

Send me a copy of my responses.

Submit

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