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PPE Resource Request Form

Please complete the following form to order your PPE supplies.

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Thank you for being an PPE distribution partner and helping to provide critical supplies to organizations within your local community. Masks and other supplies can vary depending on availability.

Use this form to place your PPE order for your center. You will provide a 30-day supply of masks or other supplies to an organization's workers.

When placing your order keep in mind the following case pack information for storage and distribution purposes:


        1 Box: 20 masks

        1 Case: 48 boxes


        1 Pack: 10 masks

        1 Case: 100 packs

        Hand Sanitizer

        1 Case: 24 bottles

To determine the quantity of masks to order please consider your storage capacity and the following:

  • The number of days per week you are distributing.

  • The number of time slots per day. 

  • The capacity of recipients per time slot.

  • The number of weeks you are participating in the program.


Example - Partner chooses to distribute Mondays and Wednesdays from 10-1pm with a capacity of 5 recipients per hourly time slot over a 4 week period. 

Max Order Quantity = 2 days x 3 hours a day x 5 recipients per hour x 4 weeks x 5 average workers per recipient = 600 boxes. That would translate to an order of 12,000 N95 masks (600 boxes x 20 masks per box).

PPE Order Form

Thanks for your order. A representative will confirm your order shortly.

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