Please use this form for
shipments within the USA
only. Export shipments will
require full container load
orders and some items may
not be available for export due
to international restrictions.
Contact us for more.
General Information for your Emergency Kit(s):
*
How many persons are you buying supplies for?
(enter total number of persons, please)
*
How many individual emergency kits do you need?
(all kits will have identical contents. If you need a
kit with different contents, then please complete a
second form for that type of kit.)
Type of packing bag:
 Duffel Bags
 sized to fit contents
 oversized
Back Packs
 sized to fit contents
 oversized
Stackable Boxes (for personal kits)
Supplies only, no bags or kit boxes needed.
Other, please describe
I want the kits to be individually pre-packed in the bags or boxes.
I want to pack them myself, please ship all supplies in bulk.
Kit Content Information:
Please tell us how many of the following items you want in each kit.
If you are asking for supplies only (not packed in kits) enter the total number you need.
If you are asking for pre-packed kits, then enter the quantity for each individual kit.
How many food bars?
 2400 calorie food bar - see here
(one bar contains the min. recommended amount  for 1 person for 3 days)
6-pack purified drinking water - see here
How many water rations?
(one ration contains the min. recommended amount  for 1 person for 3 days)
Please enter the quantities you would like for each of the following items.
Leave blank or enter '0' if an item is not needed.
First Aid Kit   personal  - 1 person  (approx 42-pieces)  - see here
First Aid Kit   medium - 5 people  (approx 52-pieces) - see here
First Aid Kit   large - 10 people (approx 81-pieces)   - see here
Flashlight (assorted colors) D-size with batteries - see sample here
12-hour glow light sticks - see here
Heavy duty leather gloves (pair)
Safety goggles with clear lens and side protection
Emergency radio - crank type, no batteries needed - see here
disposable gloves (10-pack = 5 pairs) - see here
Tooth paste
additional tooth brushes
Disposable razors (10-pack)
2-pack antibacterial soap
packs of paper tissue (10 tissues each pack)
roll(s) of bath tissue (will not fit into stackable personal boxes)
Terry cloth towels (12"x12") non sterile
Multi purpose scissors
note-pad with pencil and sharpener
rain poncho with hood
dust-mask - cone style molded (10-pack)   - see here
dust-mask - flat surgical style (10-pack)   - see here
Survival whistle with compass, compartment, lanyard and flint - see here
Emergency whistle - with shrill sound and lanyard - see here
Emergency Space Blanket to retain body heat - see here
Box Cutter style knife
Emergency stove with fuel tablets, compact folding - see here
water proof matches (50 pcs per box)
Emergency Pry Bar (open doors, windows, break through walls) - see here
Gas / water shut-off tool - prys open doors, use as hammer or axe - see here
Tube Tent Emergency Shelter (one tent can sleep 2 people) - see here
Sanitary Wet Wipes (30-pcs per pack)
foldable 2.5 gallon water bag
hand sanitizer - liquid, pocket sized 2oz bottle
Emergency CPR rescue breather (one-time use disposable unit)
toilet seat, fits standard 5 gallon plastic buckets (gray or black) - see here
5 gallon plastic bucket to fit toilet seat and to carry supplies
toilet sanitary kit, includes 12 waste bags, chemicals, wet wipes, roll of paper
Additional items that are not listed here, but we should look into including with our kits?
Please provide kit cost plus estimated shipping cost (street address needed below)
Your Contact Information:
*
First name:
 Middle initial:
*
Last name:
Company Name:
neccessary if you need shipping cost info
Street Address 1:
Street Address 2:
*
City:
*
*
State:
ZIP / Postal Code:
phone number:
fax number:
*
email address:
Please double check your spelling, thank you.
Additional Comments: