Personal Protective Equipment Request Form

PPE Request Form

Your Name:
Building and Room #:

Supplies Requested

Requests will be processed during regular business hours only.
Monday – Thursday
8:00 a.m. – 5:30 p.m.

Gloves S/M/L/XL (Box of 100)

Quantity/Size (Limit 2):

75% Alcohol Wipes (IT Equipment Only, Pouch of 50)

Quantity (Limit 1):

Alcohol Prep Pads (Box of 100)

Quantity (Limit 2):

Hand Sanitizer (1 Gallon)

Quantity (Limit 1):

Hand Sanitizer refill (Facility Contracts)


Preserve Paper Towels

Quantity (Limit 1):

Disinfectant (Re-JUV-NAL refill)


N95 Masks (Box of 20 - Health Sciences Dept. Only)


Wrist Bands

Select Color Needed (Limit 1 Pack Per Request)

Marine Blue (Monday)

Black Checks (Tuesday)

Owls (Wednesday)

Red Penguins (Thursday)

Green Burst (Friday)

Stars and Stripes (Saturday)

Orange (Sunday)