SHAC Outreach Request Form

Request For: Campus Events, Educational Materials, Condom-Mint Packets, Student Projects (Interview or Video), Etc.

We WILL NOT fill any submitted request on the same day we receive a request. All requests should be submitted at least 5 days prior to the requested pick up date. All approved requests will receive a confirmation within 10 business days. Note: Only one request per program or event will be approved.

The following information will be sent via unencrypted e-mail. If you prefer, you can complete an event request form in our office.

Please enter your group information below and select "Submit" at the end of the form.

Requested Materials - Educational

Requested Materials - Condom-Mint Packets

Condoms and Information (25 max)

Student Project Request (i.e., for interview, video, etc.)

Interview, Video, etc.

Please e-mail questions and details to

Table at a Campus Event

Campus Tabling

Are Tables Provided?

Request for a Wheel Chair

Wheel Chair requests are for UNM Faculty and Staff only. There is a 48-hour time limit. If not returned within allotted time, index number will be charged for the full amount of the wheel chair (~$400).

Wheel Chair



Is there a computer/projector provided?

Request - Other

If applicable, what will you do with the requested tangible items (i.e., educational materials, Condom-Mint packets, etc.)?

Additional Information

Statement of Acknowledgement

I acknowledge the requested items will be used for the specified purposes. I further acknowledge I will not distort any materials requested including but not limited to using condoms as materials for games, activities, or demonstrations. Please check radio button below.

Acknowledgement  * Required *