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Free Face Coverings for Non-Profits in the Aging and Disability Networks

Thanks to our colleagues at the HHS Partnership Center and the HHS Office of the Assistant Secretary of Preparedness and Response and their partners, the USPS and the National Council of Textile Organizations, we have another opportunity to offer free face coverings to non-profit community-based organizations providing direct services to older adults and people with disabilities.  

To place your order, please submit the information below as soon as possible. 

Supplies are limited. Orders will be filled primarily on a first-come, first-served basis, but we reserve the right to limit quantities in order to serve as many organizations as possible.

(Apologies for the form fields that don't make sense -- we need to include them in order to be able to quickly cut-and-paste the data into the order form we have to submit.) 

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* 1. Type of organization (SUA, tribe, P&A, etc.)

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* 2. Organization name

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* 3. Point of contact  (First and last name)

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* 4. Street Address

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* 5. City

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* 6. State (two-letter abbreviation)

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* 7. Zip code

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* 8. Please enter the word "masks" in the field below (we need this to make the data fields match the spreadsheet being used to collect orders.)

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* 9. How many masks are you requesting (in multiples of 500)?  Please enter a whole number (500, 1000, etc.)

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* 10. Just confirming -- how many cartons are you ordering?  There are 500 masks per carton. 

Please provide a whole number, using numerals -- for example, 1, 2, 10, etc.

For example:
If you are requesting 500 masks, please enter: 1
If you are requesting 1000 masks, please enter: 2 

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* 11. Point of contact for delivery (please re-enter the name you entered above if these are the same.) 

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* 12. Telephone number for point of contact

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* 13. Email address for point of contact

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* 14. Delivery instructions (such as "deliver to front door," "please call number posted on front door, because door is locked as part of our COVID precautions, etc.")

0 of 14 answered
 

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