Request Form - MaskIT Student Sample Kits
MaskIT Education Program
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Name of School or School District *
Contact Name *
Title *
Phone Number *
Email Address *
Where should we deliver the student sample kits? Please provide your full address. (outside of the US shipping charges will apply) *
How many students are in your puberty education program? *
Due to the number of orders, please allow at least 3 weeks for you orders to arrive. When would you like your student sample kits to arrive? *
How did you hear about MaskIT *
Included in your package will be some information about our public restroom solution. We would appreciate it if you would get those materials to your principle or facilities department for review. If you know whom we should speak with please provide the best way to contact them below. *
After your program runs we will send you a short survey. As a part of our ongoing efforts to maintain satisfaction and make improvements, we would appreciate learning more about your experience. By clicking bellow you commit to telling us what you think. Thank you! *
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