UsTOO International Prostate Cancer Education and Support Network: Survey

Stock up on Prostate Cancer awareness material for your next health fair or other event. Or you can pick something to raise awareness all the time!

How to Order

Simply enter the number of pieces needed next to each item.
Scroll down and fill in your mailing address.
Click the "Submit Order" button below.

*Please note that all shipments will be sent USPS or UPS Ground. If you require your package sooner than ten days from the time of ordering, please call Jackie at 630-795-1002. She can arrange for a quicker delivery at your expense.
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All material is available as is and shown and subject to availability.

Question - Not Required - Please tell us the name of your Us TOO International Chapter if applicable:

Please enter the quantities of the items below that you would like shipped to you. Note: Some items may have limited availability.

Question - Not Required - Us TOO International "SEA Blue Awareness Poster (Max 10),

Question - Not Required - Us TOO International "SEA Blue" Minority Awareness Poster (Max 10),

Question - Not Required - Special News for African Americans Poster (Max 10),

Question - Not Required - About Us TOO International Brochure (MAX 200),

Question - Not Required - SORRY WE ARE TEMPORARILY OUT OF: Us TOO International Awareness Bookmark (MAX 200),

Question - Not Required - Blue Ribbon Lapel Stickers (Max 10),

Question - Not Required - Spanish DVD (Max 10),

Question - Not Required - Special News About Prostate Cancer For Men at High Risk (MAX 100),

Question - Not Required - Special News About Prostate Cancer For Men at High Risk (en espanol) (MAX 100),

Question - Not Required - A Message about Prostate Cancer for American Indian Men, Alaskan Native Men, and People Who Care About Them,

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Question - Required - Please tell us what date you need this material by (Please allow up to 10 business days for us to ship the material).

Month

Day

Year

Question - Not Required - Please tell us how you are using this material.

Please ship to (please no P.O. boxes, as most of these orders require UPS, which will not deliver to a P.O. box):


	Title:
*	First Name: Required
*	Last Name: Required
*	Email: Required
*	Street 1: Required
	Street 2:
*	City: Required
*	State / Province: Required
*	ZIP / Postal Code: Required
*	Country: Required
*	Phone Number: Required
	Employer:
	Occupation:
	Yes, I would like to receive e-mail from Us TOO International Prostate Cancer Education and Support Network
	Yes, I would like to receive postal mail from Us TOO International Prostate Cancer Education and Support Network

Question - Not Required - For staff use only:

*

Question - Required - Please fill in the following word or phrase.

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Awareness Material