CoverAid PHL - Sewn Mask Pick Up Request

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Thank you for making masks! Please fill out this form, and we will arrange a pick up.
- Our drivers will contact you before arrival.
- Please place the masks outside of your door.
- Our driver will not come into contact with you.

Packing Instructions:
- 12 mask minimum for pick up
- Place your finished masks in a paper or plastic bag.
- Please place into an outer plastic bag as double bagging is required since the exterior bag will be sprayed with disinfectant which includes bleach during transport.
- Once the completed form is received, we will let you know the delivery date.

You are contributing to the effort to help stop the COVID-19 pandemic.

Email *

When do you want the Pick Up? *

YYYY

Your First Name *

Your Last Name *

Your cell phone number *

This will allow our driver to contact you to coordinate

Pick Up Street Address *

Pick Up Apartment / Unit Number (if any)

Pick Up City *

Pick Up State *

Pick Up Zip Code *

How many masks are ready for Pick Up? *

Which design instructions and pattern are you using? *

CoverAid PHL Fabric Mask v1

Other:

Additional Pick Up Instructions

Help our driver know how to find you or where to find the masks if you are leaving them out for pick up

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

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