SHW Materials Request

Fill out this request to obtain SHW materials, including brochures and flyers.

Name Name * First Last
Email *
Phone Phone - ### - ### ####
Date Items Needed Date Items Needed / MM / DD YYYY
Your Primary Affiliation with the University

Your Primary Affiliation with the University Faculty Staff Student Other Other
Department/Organization *
Type of Event
Number of Attendees Expected or Copies Needed
Materials - Check All that Apply

Materials - Check All that Apply Alcohol and Drugs Infocard The Struggle is Real (Coping Strategies Palm Card) Caffeine Informational Postcard Pens Aromatherapy Condoms SHW Services Bookmark Other Other
If other materials are needed or if amounts are different - Please specify here: