Surplus PPE Distribution
*PLEASE ONLY SUBMIT THE BELOW FORM ONE TIME PER PROGRAM SITE*

After distributing PPE to programs who have previously requested supplies, RIAEYC has access to a limited number of additional touch-less thermometers and surgical paper masks for distribution.

Supplies will be prioritized for child care and school-age programs that have not yet received PPE or have recently opened additional classrooms. Priority for remaining supplies will go to programs who can pick-up on one of the below dates. If you are not sure whether your program has previously received PPE, please contact your program's leadership.

IMPORTANT NOTE: Please wait for confirmation that your request can be fulfilled. It may not be possible to fulfill all requests.

Questions? Contact Shannon Jutras at sjutras@riaeyc.org.

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Program Name *
Did someone from your program pick-up PPE supplies from RIAEYC? (past distributions began in late May) *
How many staff are currently in contact with children? *
How many thermometers is your program requesting?
If available, is your program interested in additional paper surgical masks? *
RIAEYC requests at least 2 full business days' notice to fulfill your order request; you will be contacted to schedule your pickup time and receive instructions for our low contact pick-up system. *
By providing your contact information below, you agree that any PPE items received will be used to support the above child care center or school-age program and will not be used for personal use.                                                              Contact Name: *
Contact Email *
Contact Cell *
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