Skip to main content

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.