Need Face Shields?

Name *

First Name

Last Name

Phone Number (cell phone preferred) *

We might text you.

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Type of Face Shield *

Select a need (please fill out a separate for for each type).

Tier 1 - Front line Covid First Responder or Health Care Worker.

Tier 2 - Health Care type worker with possible exposure.

Tier 3 - Work with the public and need some protection.

Urgency *

Tell us when you need them.

Immediately

As soon as you can

We can wait a bit