Condoms and Lube Order Form
Please note that we do not deliver. Select a venue for pick up.
Contact details
Name *
Your answer
Email *
Your answer
Are you a top or a bottom? *
Safe Sex Kit
1 kit = 2 condoms + 2 lube
How many safe sex kits would you like to order? *
Min. 4 kits
Your answer
What will you be using the condoms for? *
Required
How often did you have anal sex in the past 6 months? *
Order collection
Please indicate where you would like to collect your order. Note that we do not deliver. *
Date for pick up. *
MM
/
DD
/
YYYY
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This form was created inside of Action for AIDS, Singapore.