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MATERIALS REQUEST FORM
Contact Information:
First Name:
Required Field
Last Name:
Required Field
Organization:
Required Field
Address:
Required Field
City:
Required Field
State:
Required Field
Zip Code:
Required Field
Phone Number:
Fax Number:
Email:
Materials Requested:
KKDF Display Materials Packet
includes: 25 Flyers
10 Buttons
3 Posters
Additional Items:
KKDF Flyers: (up to 250 per request)
KKDF Buttons: (up to 50 per request)
KKDF Posters: (up to 10 per request)
KKDF T-Shirts:
Sizes: L, XL
($3.50 each)
L
XL
Please make check payable to:
"KEEP KIDS DRUG FREE" Foundation
3180 Biscayne Boulevard
Miami, Florida 33137
1-877-628-KIDS
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