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Community Clear Mask Request Form
Hello, Members of the Deaf and Hard of Hearing Community, This form is where you can request clear face masks to comply with the requirement in many places where you need to have something covering your face in public. Please allow several weeks after your request for the volunteer mask-making team to manufacture the masks and then get them sent out to you.
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Name:
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Your answer
Email Address:
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Your answer
Mailing Address: Please enter your FULL ADDRESS, including house or apartment number, street, city, and zip code (This is very important as several cities have the same street names and we want to make sure we send the masks to the right place)
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Your answer
How many masks do you need? Two (2) per household please, We have a very limited supply of masks.
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Choose
1
2
Acknowledgement of liability: These masks are made of cotton, vinyl, and elastic materials. Please note that these are NOT medical grade masks and are NOT FDA approved, nor have they been tested or proven to protect against illness in any way. They are intended to be used as per CDC guidelines for cloth masks in public locations along with physical and social distancing. The choice to wear these masks is your own�
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No
Required
Would you like to be added to DHCC's email list to stay up-to-date with community events and happenings!
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yes
No
The clear masks looks like this: (Many thanks to Kate for making and demonstrating the masks)
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This form was created inside of Deaf-Hearing Communication Centre.
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