CoverAid PHL - Sewn Mask Pick Up Request
Thank you for making masks! Please fill out this form, and we will arrange a pick up.
- Our drivers will contact you before arrival.
- Please place the masks outside of your door.
- Our driver will not come into contact with you.

Packing Instructions:
- 12 mask minimum for pick up
- Place your finished masks in a paper or plastic bag.
- Please place into an outer plastic bag as double bagging is required since the exterior bag will be sprayed with disinfectant which includes bleach during transport.
- Once the completed form is received, we will let you know the delivery date.

You are contributing to the effort to help stop the COVID-19 pandemic.
Email address *
When do you want the Pick Up? *
MM
/
DD
/
YYYY
Your First Name *
Your Last Name *
Your cell phone number *
This will allow our driver to contact you to coordinate
Pick Up Street Address *
Pick Up Apartment / Unit Number (if any)
Pick Up City *
Pick Up State *
Pick Up Zip Code *
How many masks are ready for Pick Up? *
Which design instructions and pattern are you using? *
Additional Pick Up Instructions
Help our driver know how to find you or where to find the masks if you are leaving them out for pick up
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 NextFab Studio. Report Abuse