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Mask Order Form for Businesses (Colebrook DMV pickup)
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If other, please describe your business type:
*
Approximately how long will this order last for your organization?
One week
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This section is to tell us how many
people
you are requesting masks for. Please read the directions carefully so we can serve you best.
Who are you requesting masks for?
*
Staff/Employees
Customers
How many staff members do you have at your location per day?
*
Please enter a number greater than or equal to
0
.
How many customers do you expect per day?
*
Please enter a number greater than or equal to
0
.
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[HIDDEN] Where would you like to pick-up this order?
*
–SELECT ONE–
Colebrook DMV
Concord DMV
Dover DMV
Epping DMV
Gorham DMV
Keene DMV
Manchester DMV
Milford DMV
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Newport DMV
North Haverhill DMV
Salem DMV
Tamworth DMV
Twin Mountain DMV
What is your preferred day to pick up this order?
*
Click the dropdown to select a different date. More dates to be added in the near future.
Thursday, May 7 (FULL – Not Available)
Friday, May 8 (FULL – Not Available)
Monday, May 11 (FULL – Not Available)
Tuesday, May 12 (FULL – Not Available)
Wednesday, May 13 (FULL – Not Available)
Thursday, May 14 (FULL – Not Available)
Friday, May 15 (FULL – Not Available)
Monday, May 18 (FULL – Not Available)
Tuesday, May 19 (FULL – Not Available)
Wednesday, May 20 (FULL – Not Available)
Thursday, May 21 (FULL – Not Available)
Friday, May 22 (FULL – Not Available)
Tuesday, May 26
Wednesday, May 27 (FULL – Not Available)
Thursday, May 28 (FULL – Not Available)
Friday, May 29 (FULL – Not Available)
What is your preferred time to pick up this order?
We will do our best to accomodate your preferred time.
10:00 am – 11:00 am
11:00 am – 12:00 pm/noon
12:00 pm/noon – 1:00 pm
1:00 pm – 2:00 pm
2:00 pm – 3:00 pm
3:00 pm – 4:00 pm
Is this an original request or a follow-up/re-stock order?
Original Order
Follow-up / Re-stock Order
Unsure
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Staff/Employee Boxes Pending Approval
WHOLE NUMBER ONLY
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Customer Boxes Pending Approval
WHOLE NUMBER ONLY
Hidden
Staff/Employee Boxes Received
ONLY FILL THIS OUT IF THEY HAVE PICKED UP THEIR ORDER
Hidden
Customer Boxes Received
ONLY FILL THIS OUT IF THEY HAVE PICKED UP THEIR ORDER