CRA Partner Supplies Request Form

Please complete this form AT LEAST 7 days before your planned pick-up so we can ensure we have enough supplies for our participants and all of our partner organizations. Also please note, we are no longer doing partner pick ups on Saturdays due to capacity- another weekday evening will be added in the near future.

We always accept & appreciate in-kind donations of hygiene products, clothes, condoms etc...

Filling out this form is for planning purposes and we do not guarantee that we have everything in stock. If you are NOT an existing partner organization with CRA, please contact Cris Johnson cris@anypositivechange.org.

DUE TO COVID-19 QUARANTINE, PICK-UP CAN ONLY OCCUR THROUGH THE DOOR. QUESTIONS? E-MAIL cris@anypositivechange.org
Email *
Have you been approved to pick up bulk supplies from CRA? *
Your Name *
Your Phone Number *
Which Partner Organization Are You With? *
Which Supplies Does Your Organization Need? *
Required
How many of the above? *
Please describe in detail the quantity and type of supply you are requesting (ex: 2 boxes of 23 g syringes, 5 boxes of Naloxone etc.)
Which Day for Pick-Up of Supplies? Note: Saturdays are cancelled and another week day evening will be added soon. *
What Date? Please make sure you are requesting at least a week in advance *
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Around what time frame? Cris will contact you if flexibility is needed. *
Any Other Relevant Info?
A copy of your responses will be emailed to the address you provided.
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