Mask Request Application for Schools
Thank you for your interest in the BStrong back to school initiative with Global Empowerment Mission to provide PPE in Schools. We look forward to helping maintain safety at our nation’s school this fall. If your school is in need of a PPE donation, please complete the following questionnaire and note that this application should only be used for individual schools. This application cannot be used to apply for PPE donations for an entire school district. If you are a representative for a school district please send an email to: donations@globalempowermentmission.org Or call (800)995-7604 ext. 2.

All questions on this application must be completed and an accurate mailing address and contact phone number must be provided. Please allow five business days for your application to be reviewed and you may be contacted by a member of the BStrong/Global Empowerment Team to review for school’s application and PPE needs.

If you have additional questions please email: Donations@GlobalEmpowermentMission.org

Or call (800)995-7604 ext. 2.
Email address *
What State is your school or educational facility in?
What County is educational facility in? *
Full name of your school or educational facility?
Type of educational facility? *
Your full name and position at the educational facility? *
Direct Cell Phone # (Must be able to reach you to approve application) *
Full mailing address of educational facility? (Must include city, state, & zip code) *
Is this a private or public educational facility? *
How many faculty members do you have on staff? *
How many students do you currently have attending classes onsite daily? *
P.P.E. needs at your location?
Do you currently have masks at your educational facility? *
Is there any other pertinent information you need to provide about this request?
STATEMENT OF AGREEMENT *The disclosure of information on this form is voluntary; however, missing information may prevent assistance. Application submission does not guarantee approval. A committee will review and make decisions based on the organizations current funding and the urgency of each situation. By agreeing below, you solemnly swear that the information contained herein is reported in true faith. I UNDERSTAND AND AGREE TO THE TERMS & CONDITIONS STATED ABOVE. *
Required
Submit
Never submit passwords through Google Forms.
reCAPTCHA
PrivacyTerms
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy
Google Forms