COVID-19 Personal Protection Equipment & Materials | DONATION FORM
RequiredRequired Question(s)
The President has called upon various industries to donate what they are able to provide in terms of N-95 respirators and other supplies to hospitals. It is unclear how many respirators or other supplies will be forthcoming to this area out of Michigan's allocation from the Strategic National Stockpile, but the number is unlikely to meet the need. We can expect current clinical supplies to be exhausted. 

Businesses can drop off materials between 9:00am and 4:00pm beginning Monday, March 23rd. A designated and secured area for materials is available at the SVSU Ryder Center (click here to see map). Please note, once this Donation Form is completed, the contact will receive details of the door location and process to arrange for donation.
 
If you have any questions, please email Dallas Rau at d.rau@thrivegreatlakesbay.org or Tera Szeliga at tszeliga@greatlakesbay.org.
 
Required 1.

Organization Name

 

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Required 2.

Name of Individual Completing Survey

 

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Required 3.

Phone and Email Address of Individual Completing Survey 

 

350 characters left.
Required 4.
How many N-95 face masks would your organization be able to donate? 
 

350 characters left.
Required 5.
How many hand sanitizers (>60% alcohol) would your organization be able to donate??
 

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Required 6.
How many disinfectant wipes (>60% alcohol) would your organization be able to donate? 
 

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Required 7.

 How many High Efficiency Air Filters would your organization be able to donate? 

 

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Required 8.

How many boxes of gloves would your organization be able to donate? (Please also indicate type and size) 

 

350 characters left.
Required 9.

How many pairs of goggles would your organization be able to donate? 

 

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Required 10.

How many clear face shields would your organization be able to donate? 

 

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Required 11.

How many surgical gowns would your organization be able to donate? 

 

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Required 12.

How many sets of clear safety glasses would your organization be able to donate? 

 

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Required 13.

How many M4 red top tubes with viral media would your organization be able to donate? 

 

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Required 14.

How many Dacron swabs (for sample collection) would your organization be able to donate? 

 

50 characters left.
15.

Please share any additional feedback or materials your organization would be able to donate that would be helpful in our regional efforts: 

 

1000 characters left.