Condom Distribution

Please use this platform for mail-order condom packets. We offer free condoms by mail or delivery. Packets include 20 condoms and lube.

For additional questions or information, please e-mail vivian.ching@cpacs.org.

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* 1. Please enter your information below. We will only call if further confirmation is needed.

Name *

Address *

City/Town *

State/Province *

ZIP/Postal Code *

Email Address

Phone Number *

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* 2. Please indicate how many PACKETS you would like to order (There are 20 variety condoms per packet).

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* 3. This order form was quick and easy to use.

Agree

Disagree