Bristol Purifier Distribution Program

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Please fill this information out in its entirety so we can get you on the list for a purifier(s). That said, we want to thank all of our partners for helping us get here. Special thanks to:

Bristol Area Ministerial Alliance
HOPE for Bristol
Pastor Eric Fields and Grace Bible Church
Rev. Jackie Nophlin and Household of Faith Community Church
Rev. Steven Davis and BCCR Ministries
Rev. Kris Aaron and First Baptist of Bristol
Bristol Rotary
Bristol Baseball/Bristol State Liners
BTN Mayor Luttrell
BTN Council Members Lea Powers, Vince Turner, Margaret Feierabend, and Mark Hutton
United Way
Genan Foundation
VADEQ's Office of Environmental Justice
Anath Paczuski Qualls and her husband
Steve Johnson
Angel and Lynn Dougherty
Peter Buhls
Ron and Amanda Fox
...and countless other donors

THANK YOU!

Email *

Please give your full name *

Please give the number of people in your household. *

Please give your complete home address *

Please give your BEST telephone number. *Please note that you must answer your phone when we call to pick up your unit(s). *

Please give your BEST email address. *

Please give a brief description of your financial AND/OR health need. Please describe this in your own words. We do not want documentation. *

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

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