Hand Sanitizer Request Form
If you run an organization/ food pantry or lead a tenant association in a large building, please fill out this form if you would like to pick up a 1 gallon bottle of hand sanitizer. Please keep in mind that supplies are limited. Hand Sanitizer pick ups will be available Mondays and Fridays from 2 PM - 5 PM at 1077 Nostrand Avenue (Between Lefferts Avenue and Lincoln Road)
Email address *
First Name *
Your answer
Last Name *
Your answer
Organization Name *
Your answer
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