Order form for TUSDM Community Engagement Activities
Orders are filled in the order they are received. Please give at least 2 weeks notice. You will be contacted to arrange a pick up time. All materials are picked up and returned to the Dept. of Public Health office--room 1534.
* Required
Organization
Your answer
Name of Person Making Request
*
Your answer
Cell Phone Number
*
Your answer
E-mail Address
*
Please note that we use email to communicate so provide one that you check!
Your answer
Event Details
Name of Event
*
Your answer
Date of Event
*
MM
/
DD
/
YYYY
Requested date for pick up of materials (Note: this will be confirmed by Nancy Marks)
Between 8:30 and 4:00 Monday-Friday
MM
/
DD
/
YYYY
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