Requesting PPE in Yuba County

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* 1. Business Name

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* 2. Business Physical Address

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* 3. Industry Type

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* 4. Contact Name and Title

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* 5. Phone Number

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* 6. Email Address

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* 7. How many employees does your business have?

0-5

6-15

16-25

26-50

more than 50

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* 8. What other supplies or information would be useful to you and your business? For example: Plexiglas shields, air purifiers, cleaning supplies, etc.

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* 9. What are your biggest challenges as a Yuba County business?