Fillable FREE HAND SANITIZER- DETAILS AND REQUEST FORM Businesses (City of Sumner)

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FREE HAND SANITIZER- DETAILS AND REQUEST FORM Businesses (City of Sumner)

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FREE HAND SANITIZER- DETAILS AND REQUEST FORM
Businesses can request up to two (2) gallons of gel hand sanitizer for use within the business by
completing this form. Only businesses within Sumner’s city limits are eligible. The hand sanitizer
is intended for use by the business and not intended for resale. Businesses will need to arrange
for pick up at the locations on the times and dates listed below. The hand sanitizer will be
distributed on a first come first serve basis until gone, up to two per business.
Pickup locations and dates:
• Monday 12/21, 1:00pm-4:00pm: Sumner Main Street Association Offices (923 Kincaid Ave)
• Tuesday, 12/22, 9:00am- Noon: Sumner City Hall (1104 Maple St.)
• Tuesday 12/22, 1:00pm-4:00pm: Sumner Main Street Association Offices (923 Kincaid Ave)
• Wednesday, 12/23, 9:00am- Noon: Sumner City Hall (1104 Maple St.)
• Wednesday12/23, 1:00pm-4:00pm: Sumner Main Street Association Offices (923 Kincaid Ave)
• Tuesday, 12/29, 7:30am - 3:00pm: Sumner City Shops (4711- 142nd Ave E.)
• Wednesday, 12/30, 7:30am - 3:00pm: Sumner City Shops (4711- 142nd Ave E.)
Please bring this completed form with you at time of pickup.
*Business Name
*Business Address
*Contact Name
*Contact Cell Number
*Contact Email Address
*Required
Desired amount of hand sanitizer? One gallon Two gallons
Applicant/business owner certifies that the hand sanitizer provided will be used for operational
purposes and is not intended for resale.
Signature _______________________________________________________
Date ___________________________
For questions, contact Lana Hoover at 253-266-4904 or lanah@sumnerwa.gov or
Kelly Harter at 253-299-5740 or kellyh@sumnerwa.gov
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FREE HAND SANITIZER- DETAILS AND REQUEST FORM Businesses (City of Sumner)

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Completed 24 January 2021

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