Skip to form

City of Golden

911 10th St., Golden, CO, 80401, US


City of Golden Face Mask Request Form

To protect the safety of employees, residents, customers, and visitors, and to slow the spread of COVID-19, the City of Golden has recommended that customers and employees wear a face mask or other non-medical facial covering while in public. To assist businesses and those at risk from serious illness, the City of Golden is providing a limited number of disposable face masks for business experiencing difficulties supplying their own. These masks can be given to customers who lack their own facial coverings, or for employees to wear during their shifts. These masks are not the N95-type masks used by medical personnel and first responders, rather they are available through normal distribution channels. Masks come in a box of 50 disposable masks, and requests will be capped at two (2) boxes or 100 masks. 

Due to the limited quantities available, businesses should provide face coverings only for customers for whom alternative shopping arrangements are not feasible. The City of Golden does not intend to be a regular supplier of face coverings, rather a temporary provider while businesses source their own. Any business that has received masks previously may request additional masks, however it is not guaranteed to be fulfilled. Masks will be delivered by City staff on Fridays (may be altered in the event of a holiday). 

Please email Alex Mansfield at if you have questions.

Contact Name

Business Address

Full Date

Be sure to verify that you are not a robot by using the Captcha tool at the below.
Having reCaptcha issues? Click here to reset the widget.