PBDG 2021 PPE Request Form: Round 4
Professional Business Development Group is partnered with Oregon Health Authority and Business Oregon to ensure that the companies we serve have the supplies they need to run their businesses safely. We are distributing PPE supplies free of charge.

This program will be available until supplies run out. PPE totals given to each company will be calculated based on the number of employees.

Boxes will include
- Hand Sanitizer Dispensers
- Nylon Gloves
- Vinyl Gloves
- Sanitizing Wipes
- Disposable Masks
- Hand Sanitizer
- N95 Masks
- Infrared Thermometers

After we have received your information, we will contact you with additional information for pick up/drop off location, date, and time.

Disclaimer: PPE distribution is intended for small businesses. Business Oregon defines small businesses as having 100 employees or less. You must meet this requirement to qualify for the free PPE.

Note: If the business owner is not available for pick up, please let us know who to expect when we speak with you. In compliance with CDC guidelines, we ask that any person in coming into our space wear a mask.*

If you have any questions, please email Yetty at admin@pbdgweb.com.
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Contact Name *
Company Name *
Phone Number *
Email Address *
Number of Employees *
Company EIN *
PBDG serves primarily businesses in the construction industry. If you are in a different industry, please tell us about your business. *
Website (If applicable)
Contact info for person who will be picking up
Commercial/Mixed (check all that apply) *
Required
Single Family (check all that apply) *
Required
Construction Divisions (check all that apply) *
Required
Scopes of Work *
For reporting purposes, we need to collect some demographic data from you.
What is your race? *
Required
What is your gender? *
Please check all that apply to you. *
Required
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