COVID-19 Kits for Migrant Workers Request Form
You can fill out this form to request up to five free COVID-19 kits from Legal Aid of Nebraska in partnership with the National Center for Farmworker Health to distribute to migrant workers in your community. Each kit contains N-95 masks, hand sanitizer, sanitizing wipes, latex gloves, disposable thermometer and a pulse oximeter packaged together in a reusable drawstring bag.
How many kits do you need? *
Organization *
First Name *
Last Name *
Mailing Address *
Address Line 2
City *
State *
Zip Code *
Email Address *
Phone Number
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