Request FREE Masks
Mask requests for people working on the front lines (with the public), seniors, at-risk individuals, and their families. Please complete the form below to request HOMEMADE cloth masks. We are NOT selling masks. We do not have N95 masks, or any purchased mask.
* Required
Who are the masks for?
*
Senior (65+)
Law enforcement (solid color/dark)
Healthcare workers
Working with the public
Working with co-workers
At risk individual (medical reasons)
Other:
Can you or someone pick the masks up (in Santa Clarita)?
*
Yes
No (Due to high demand we are no longer shipping masks)
How many PEOPLE need masks (male or female, child, toddler, etc)?
Your answer
Please provide additional information about the individual, family, or facility that needs them.
*
Your answer
Name (first & last)
*
Your answer
Email Address
*
Your answer
Phone Number
*
Your answer
Submit
Never submit passwords through Google Forms.
This form was created inside of Small Dog Creative.
Report Abuse
Forms