Materials Request Form Name* First Last E-mail* Enter campus e-mail address Confirm campus e-mail address Who/what are you ordering for?*e.g. Hess HallPick-up or delivery?*Please note, materials are delivered 8 a.m. - 5 p.m. Monday-Friday to on-campus buildings only.Pick-upDeliveryWhere would you like the materials delivered? Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code By what date do you need the materials?* Date Format: MM slash DD slash YYYY What materials would you like to request? Alcohol C.U.P.S. Cards Consent Posters Survival Guide to Stress Booklet What Consent message(s) would you like? Alone With You Does Not Mean Yes Kissing Does Not Mean Yess DMs Do Not Mean Yes House Parties Do Not Mean Yes Dating Does Not Mean Yes Incapacitation Does Not Mean Yes Silence Does Not Mean Yes Maybe Does Not Mean Yes Safer Sex & Safety SuppliesSafer sex supplies come in assortment packs suitable for different sized groups. For groups larger than 40, please contact CHEW staff at wellness@utk.edu. Small (groups of 10 or fewer) Medium (groups between 10-20) Large (groups between 20-30) Extra Large (groups between 30-40) If the item you would like is not in the list, please describe it:How many of each item do you need?*e.g. Consent Stickers: 20