Online Form Submission for Courts to Request Masks / PPE

Court Requests for Masks & PPE Donations

The form below can be used by judges, court personnel and/or courthouse representatives to submit a request directly to Mask Up For Justice for donations of face masks and/or PPE for your courthouse. Only authorized court personnel may make such requests. Once the request is submitted, Mask Up For Justice will be in touch to further discuss the details of your request and what we can do to help your court with safe resumption of jury trials.

Name

First Name

Last Name

Court Affiliation

Phone Number

(###)

###

####

What are your mask / PPE needs?

Please describe what your court is in need of, including: How many masks do you need? What type would you prefer? Will they be used solely for jurors or for courthouse personnel as well? Please specify, if possible, the total number of each product needed.

What date do you need the masks / PPE by?

Do you currently have trials scheduled in your court?

YES

If yes, what date is each trial scheduled to begin?

Please specify the date for each trial, as well as which judge the trials will be held before.

Address Where Masks & PPE Should Be Shipped

Additional Message / Anything Else We Need to Know?