Vulnerable Populations Distribution Plan
Organization's Name
Your answer
Point of Contact
Your answer
Email Address
Your answer
Organization's Address
Your answer
Organization's Zip Code
Your answer
Organization's Telephone Number
Your answer
Organization's Telephone Number
Your answer
Type of Organization
Is the Organization willing to distribute filters to city residents?
If Yes, how many filters can they take?
Your answer
After initial distribution, do they want to be contacted to do additional distribution?
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Additional Terms