Cloth Face Covering Request Form
UCLA is coordinating with campus partners to procure reusable cloth face coverings for employees who will return to in-person work as a part of UCLA's Stage 2 Ramp-Up scheduled to begin on May 26, 2020.
Indicate those employees in your department who will return to in-person work on or after May 26, 2020 as part of Stage 2 Ramp-Up. Departments will be allocated three cloth face coverings per employee.
Given current supply shortage, allow 7-10 business days from date of order. Note that form submission does not guarantee approval or distribution of a cloth face covering.
Choose your method of entry.
Submit via Spreadsheet, Good for multiple entries
Submit via Form, Good for small number of entries (suggested for ten or fewer entries)
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