Application for COVID-19 PPE Funds

Texas Municipal League has donated $5000 to the Texas Fire Chiefs Association so we can distribute these funds to our member departments in need of additional PPE. Please fill out the following survey describing your PPE needs in COVID-19 response.

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* 1. Contact Information

Name and Title

Department Name

Address

City/Town

ZIP/Postal Code

Email Address

Phone Number

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* 2. What are your departments PPE needs for COVID-19 response:

Need #1

Need #2

Need #3

Need #4

Need #5

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* 3. Amount of funds requested:

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* 4. More details about your request: