Tobacco Prevention and Cessation Program SOS Collateral Material Request Form

NOTE: Request for collateral material must be received at least three weeks before the event. Due to budgetary restraints, SOS cannot provide for all your promotional needs. Please consider other sources for collateral materials.

Name of Organization:
Contact Person:
Address:
Telephone:
Email Address:
Name of Event:
Event Date and Location:
What Counties Will Your Event Service?:
Will the event be advertised?:
Request Specific Collateral Item: