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COVID-19 Mask Request

  1. Mask Request Form

    This form is for residents or businesses in the City of Green to request a homemade mask. These masks will only be distributed when available and priority will go to those who need them most. Masks are for Green residents and businesses only.

  2. I am requesting for*

  3. Are you employed in the healthcare field?*

  4. Are you 65 or older or is someone in your house immunocompromised?*

  5. Leave This Blank:

  6. This field is not part of the form submission.