COVID-19 DONATIONS INTAKE
Thank you for your interest in offering donations of critical supplies needed at this time due to the ongoing coronavirus situation. Please use this form to provide contact information and some basic information about what items you have available to donate.
CONTACT PERSON
First Name *
Last Name *
CONTACT INFORMATION
Email *
Phone *
Town *
DONATION INFORMATION
Are you offering a donation on behalf of an organization or company?
Clear selection
If you selected "Yes", please provide the organization or company name.
What items do you have available to donate? (check all that apply) *
Required
If you selected "Other", please specify the item(s) you have available to donate.
Are you able to drop off your donation to wherever it is needed, or do items need to be picked up? *
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