Mask Request - Be Kind Needham
If you would like to request a mask from Be Kind Needham, please complete the questions below and a volunteer will respond.

** PLEASE NOTE: Quantities are limited. Be Kind Needham is a 100% volunteer based organization dedicated to producing and distributing masks to Needham's most vulnerable population. The masks are not medical grade, but they can provide a level of protection for you if you absolutely must leave your home. All Be Kind asks in return is that you smile under your mask : )
Email address *
Your Full Name *
Best Phone/Cell Number to reach you:
Your Apt./Home #: *
Street Name: *
Please select zip: *
Number of masks: *
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy