JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
Donate PPE in the Central Coast
If you have PPE to donate please let us know the type and quantity and we will match the donation to a local Health Care provider in need.
Parent Site:
https://www.ppe4scc.org
PLEASE SHARE:
Go Fund Me for PPE in Santa Cruz County:
https://www.gofundme.com/f/santa-cruz-need-ppe-now-support-ppe4scc
A portion of funding is allocated to Encompass health workers through this Go Fund Me:
https://www.gofundme.com/f/help-protect-santa-cruz-community-service-workers
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Email
*
Your email
Full Name
*
Your answer
Organization Name
Your answer
Phone
Your answer
Address
Your answer
What can you donate?
*
N95 Grade Masks
Surgical Masks
Face Shields
Gloves
Garments / Gowns
Home Sewn Washable Masks
Other:
Required
What are the quantities of what you checked above?
*
Your answer
How have the supplies been stored?
*
Your answer
Can you deliver the supplies or will you need them picked up?
*
Deliver: Anywhere
Deliver: Limited range.
Pickup
Other:
Anything else?
Your answer
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of Idea Fabrication Labs.
Report Abuse
Forms
