RE-1 District Provided Mask and PPE ordering form
1.
Please select the type of mask you are requesting from the district (see mask guidance on HR webpage for more information on mask types)
Double layer cotton mask (reusable, district will provide 2 per quarter)
Double layer cotton mask with 'see through' mouth (reusable, district will provide 2 per quarter)
Quilted layer (reusable, district will provide 2 per quarter)
KN95 (disposable following limited number of uses, Governor is providing 1 per week)
I am choosing to provide and wear my own mask
Other (medical procedure mask)
2.
Are you requesting a clear face shield? (these will be available based on employee need and work setting). These do NOT replace a mask and would be worn in addition to a mask
Yes
No
3.
Name
4.
School or department
5.
Role
6.
Any additional comments for HR
Current Progress,
0 of 6 answered