Urgent Call for Supplies

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* 1. Do you have any Personal Protective Equipment (PPE) in stock such as: masks, gowns, face shields, respirators, gloves, hand sanitizer, sanitizing equipment, cleaners, cleaning wipes, other essential products?

If yes, please complete this form

Yes

No

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* 2. Please list the items you can sell, donate and or manufacture:

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* 3. Do you have the ability and capacity to manufacture any PPE products?

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* 4. Do you want to donate or sell your products?

Donate

Sell

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* 5. List what is in stock or and what needs to be manufactured:

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* 6. How many

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* 7. How fast can they supplied

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* 8. Contact name

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* 9. Company

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* 10. Email address

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* 11. Phone number