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State of Alaska E-cigarette Resources for Youth Order Form
Please complete this order form for State of Alaska e-cigarette materials to share with youth in your communities and schools. All materials will be provided and shipped at
no cost
to you.
1.
Number of
Brain Live Vape Free posters for teens ages 13-17
you would like? (Limit: 25)
2.
Number of
Stress Live Vape Free posters for teens ages 13-17
you would like? (Limit: 25)
3.
Number of
Vaping Hurts the Environment posters for middle and high school student
would you like to order? (Limit of 25)
4.
Number of
Vaping Can Cost You posters for middle and high school students
you would like? (Limit: 25)
5.
Number of
Toxic Metals posters for middle and high school students
you would like? (Limit: 25)
6.
Number of
Perfecting My Jump Shot posters for middle and high school students
you would like? (Limit: 25)
7.
Number of
Toxic Chemicals posters for middle and high school students
you would like? (Limit: 25)
8.
Number of
Healthy Lungs Breath Clean Air posters for elementary students
you would like? (Limit of 25)
9.
Number of
Not Vaping Helps Me Stay Health posters
for elementary students
you would like? (Limit of 25)
10.
Number of
Live Vape Free rack cards for teens ages 13-17
you would like? (Limit: 100)
11.
Number of
Live Vape Free tearaway cards for teens ages 13-17
you would like? (Limit: 100)
12.
Number of
Life is better Vape Free postcards
you would like? (Limit of 50)
13.
Number of
Alaska Schools can help protect youth mental health by addressing nicotine use fact sheets
you would like?
(Limit of 50)
14.
Number of
E-cigarette use, suspension, and academic outcomes among Alaska high school students factsheets
you would like? (Limit: 50)
15.
Number of
Alaska teens and e-cigarette use factsheets
you would like? (Limit: 50)
16.
Number of
Smoke Salmon Not Tobacco Version 1 stickers for middle and high school students
you would like? (Limit: 100)
17.
Number of
Smoke Salmon Not Tobacco Version 2 stickers for middle and high school students
you would like? (Limit: 100)
18.
Number of
"Your Path to Quit Tobacco Can Start Today"
- version A rack cards (4" x 9") you would like? (Limit: 100)
19.
Number of
Smoke Salmon Not Tobacco bookmarks for middle and high school students
you would like? (Limit: 100)
20.
Number of
Live Vape Free texting program pens for teens ages 13-17
you would like? (Limit: 50)
*
21.
Please enter your mailing information below:
(Required.)
Name of package recipient
*
Name of organization
Mailing address
*
Address 2
City/Town
*
State/Province
*
AL Alabama
AK Alaska
AS American Samoa
AZ Arizona
AR Arkansas
CA California
CO Colorado
CT Connecticut
DE Delaware
DC District of Columbia
FM Federated States of Micronesia
FL Florida
GA Georgia
GU Guam
HI Hawaii
ID Idaho
IL Illinois
IN Indiana
IA Iowa
KS Kansas
KY Kentucky
LA Louisiana
ME Maine
MH Marshall Islands
MD Maryland
MA Massachusetts
MI Michigan
MN Minnesota
MS Mississippi
MO Missouri
MT Montana
NE Nebraska
NV Nevada
NH New Hampshire
NJ New Jersey
NM New Mexico
NY New York
NC North Carolina
ND North Dakota
MP Northern Mariana Islands
OH Ohio
OK Oklahoma
OR Oregon
PW Palau
PA Pennsylvania
PR Puerto Rico
RI Rhode Island
SC South Carolina
SD South Dakota
TN Tennessee
TX Texas
UT Utah
VT Vermont
VI Virgin Islands
VA Virginia
WA Washington
WV West Virginia
WI Wisconsin
WY Wyoming
ZIP/Postal Code
*
Country
Email Address
*
Phone Number
*
For additional public education materials about e-cigarettes to share on television, radio, online and social media in your community, please email
tobacco@alaska.gov
.
Let us know your intended audience (e.g. general public, parents/caregivers, educators, youth, etc.).
Available e-cigarette PSA materials include:
30-sec and 15-sec videos for parents/caregivers and youth
30-sec radio PSAs for parents/caregivers and youth
Online digital messages to place on websites for parents/caregivers and youth
Social media graphics and comment copy for parents/caregivers, educators, and youth.
You can also explore available resources on
AlaskaQuitLine.com
.