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Firewood Community Safety Initiative
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ORDER DATE06/11/26
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Instructions:
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Update this order form with the supplies your bank needs from the provided list.
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Engage with your firewood community during pick-ups or
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deliveries to find out who needs the supplies the most.
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Collect recipient info through a short survey.
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Distribute tools and teach about why they are safety essentials.
 SHIP TO:
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 YOUR NAME HERE
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 Let us know if you need more by September 1st, 2026. Attn: ORGANIZATION NAME HERE
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 ADDRESS:
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 Town, State, Zip Code
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 Phone: (000) 000-0000
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 Item # Description Quantity Unit Price Total
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1Behrens Metal Ash Bucket with Lid- Set of 20 $ 59 $ -
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2Rotary Chimney Sweep Kit0 $ 50 $ -
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3Magnetic Stove Thermometer0 $ 10 $ -
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4Moisture Meter0 $ 19 $ -
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5Temtop Indoor Air Quality Monitor0 $ 40 $ -
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**form is preset to calculate totals from each item
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 SUBTOTAL $ -
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Form Version:1 TAX $ -
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Created:May 1, 2026GRAND TOTAL $ -
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*AGH covers all cost! We just have to keep track
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Additional Notes:
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Reorders are allowed once the first order of supplies is distributed
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Quantity restricted to 20 of each item in each order.
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Storage space is required for maximum orders.
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