Adopt-A-Hand Sanitizer Interest Form

Help stop the spread of COVID-19 in our community! The City of Alexandria, in conjunction with the Alexandria Health Department, is seeking community partners to host and/or adopt City-owned hand sanitizer stations for public use. Community partners can fill one of two roles: sanitizer station hosts who place a hand sanitizer station at their business, organization, or facility site; or sanitizer station adopters who monitor and care for a hand sanitizer station on nearby public property (e.g. park, street corner, transit facility).

Host/Adopter Expectations
  • Fund hand sanitizer fluid refills (estimated cost of $50-$100 per month)
  • Periodically inspect the hand sanitizer station, reporting its condition to the City
  • Refill the hand sanitizer fluid as needed
  • Make the hand sanitizer station available for use at your site (hosts only)
Host/Adopter Benefits
  • Help our community continue to safely remain open, by providing an important infection prevention measure
  • Include your logo on the hand sanitizer station that you host or adopt
  • Use of a City-funded hand sanitizer dispenser at your site (hosts only). Note: the dispenser will be this unit or similar.
If you have any questions about the program, or if you need assistance filling out the interest form, please contact sarah.popelka@alexandriava.gov.
1.Business/Organization Name(Required.)
2.Business/Organization Type (check all that apply)(Required.)
3.Address (or Location)(Required.)
4.Contact Name(Required.)
5.Contact Phone Number(Required.)
6.Contact Email(Required.)
7.Which of the following are you interested in?(Required.)
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