Request MVMask
Please use this form to request fabric MVMask face masks from PDX Hackerspace.

We are a non-profit corporation located in the Kenton neighborhood of N. Portland. We are mass producing fabric face masks and making them available to the general public at no cost.

PDX Hackerspace will only use your contact information to communicate about delivering MVMasks to you. You will not be put on a mailing list and we will not sell your information.
Email *
MVMask (fabric with a filter pocket)
Name *
Organization
Feel free to leave blank for personal use
Phone Number
We only use this as a backup means to contact you if we fail to reach you via email.
Delivery Address
If you do not yet have a known delivery address, please leave blank.
Quantity of Adult Masks *
Quantity of Child Masks *
Use
This optional information will allow us to understand better how masks are being used.
Other comments or information
Please let us know any other details that will help us qualify the priority of this request
A copy of your responses will be emailed to the address you provided.
Submit
Never submit passwords through Google Forms.
reCAPTCHA
This form was created inside of PDX Hackerspace. Report Abuse