PRC September Request Form

 
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1. Providing resources to our community is our mission: to educate, engage and encourage.

Please complete this request form for literature and brochures. Items such as stickers, bookmarks, etc. will be included based on availability.

These are at no costs to you and your agency, however, remember we serve 23 East Texas counties. All requests are based on inventory and grant funding.

Your initials here to confirm acknowledgment of this information:
2. Your Information
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3. County school is located in:
4. Would you like to receive a sample package of age appropriate material? This will be delivered with your Red Ribbon Week supplies in September.
5. DETAILED Menu: (use either the Basic Components or the Detailed listing - not both)
BrochuresSpanishFor Grades
Alcohol
Club Drugs
Cocaine
Crack
Crystal
HIV/AIDS
Inhalants/Huffing
Marijuana
Meth
RX Drugs
Rohypnol
Steroids
Smokeless Tobacco
Tobacco
Getting Help!
6. Children workbooks (limited stock)
51025
Being Me and Tobacco Free Grades 1-4
Drugs Can't Stop Me Ages 6-9
Tobacco is Trash Grades 4-8
Tobacco Smash It! Grades 4-8
Tobacco Stinks Grades 4-8
7. SOS: Spotlight On Smokeless is a curriculum that can be used in your school to give youth (grades 1-6) the knowledge and skills needed to resist smokeless tobacco use. (Notice-our new grant does not offer stipends.) These are free! Please write the quantity you need:
8. Which posters would you like to receive? Stickers, children's activity books and other available items will be added also (as supplies last):
Quantity
Drugs are Dumb
Bunny: (drugs, meth, alcohol, smoking, vomit)
Surprised you're hooked
Ecstasy
Your drink you lose
Buying tobacco, lose your license
Drunk Driving
Pot mayks you stoopid
Steroids
9. How else can Prevention Resource Center be of assistance to you? We'll send you the link to complete that form for details:
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