Air Purifier Request Form
Residents in Oakland are checking the air quality to see if we can go outside, and that unhealthy air is getting into our homes. We are taking requests for air purifiers for Oakland folks that cannot afford them. This is a volunteer run effort and we cannot guarantee that your request will be filled (be we will try our best)
The process: Fill out this form with your information. We will be crowd funding for the cost of air purifiers. Once we receive enough funds we will contact you directly to fill requests in the order they are received.
Purifiers range in price from $50-$150 depending on size.
Additional questions email
tracecord@gmail.com
Donations Accepted at -
PayPal:
tracecord@gmail.com
Cash App: $tracecord
Venmo: @Tracey-Corder
Daily accountability tracking will be posted on Twitter at @traceyecorder
*Required
Name
*
Your answer
Pronouns (
https://www.mypronouns.org
)
Your answer
Zip Code
*
Your answer
Email Address
Your answer
Phone Number
*
Your answer
Square Ft of your home? (to help determine the size of the air purifier we'll send you, it's okay to estimate)
Your answer
Are there elders (people over 65) in your home?
*
Yes
No
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google.
Report Abuse
-
Terms of Service
-
Privacy Policy
Forms