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 Hall Pick-up or delivery?*Please note, materials are delivered 8 a.m. - 5 p.m. Monday-Friday to on-campus buildings only. Pick-up Delivery Where 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?* MM slash DD slash YYYY What materials would you like to request? Alcohol C.U.P.S. Cards Survival Guide to Stress Booklet 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. Alcohol CUPS cards: 20