Covid Community Response

First Name

Last Name

Phone

Select County

Latitude

Longitude

Drag the map marker to set you location.

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Do you wish to volunteer your time?

Do you have access to Personal Protective Equipment which is available for donation?

Do you have access to a 3D printer?

Access to Car?

Are you over 18?

Can we contact you by email?

Are you part of a group?

3D Pinter Make

3D Pinter Model

Material

Notes

Please describe what PPE supplies you have for donation

Volume of items for collection (How big is your package?)

Eircode (To enable a quick pickup from our couriers)

General availability times for collection