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Connecting to Community Resource Toolkit Materials

Mark the materials you are requesting. You will receive 15 printed copies of each material marked. If you need more than 15 copies, please complete the event section of this form.

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* 1. Mark the materials you are requesting from the base toolkit.

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* 2. Mark the materials you are requesting from the resources for low-income individuals toolkit.

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* 3. Mark the materials you are requesting from the physical and emotional health and wellness toolkit.

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* 4. Mark the materials you are requesting from the pregnancy, children, teens and families toolkit.

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* 5. Connecting to Community Resource Toolkit Materials for Special Events:

If you are requesting more than 15 copies of a printed material, indicate below which material(s) you are requesting and the total number of copies you need of each.

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* 6. Briefly describe the special event and how you plan to distribute each printed material, and the date of the event.

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