Materials Request Form
Please be sure to use Chrome as your browser for this form
Event Name
Event Date
Donor Network West Staff Contact
Please select...
Ayanna Anderson
Beverly Mayer
Candee Candler
June Wallace
Lalaine To
Lisa Stanley
Marcella Corona
Mike Freise
Noel Sanchez
Theresita Gonzalez
The CDL in your area
Region
Please select...
East Bay
Fresno
Nevada
NoMo
South Bay
West Bay
DSA
Your Name
Your Email
Event Type
Please select...
Tabling
Hospital Presentation
School Presentation
DMV Presentation
Faith Based
Symposium/Forum
Conference
Pink Dot/Red Heart Club
Restock (not attached to an event)
Other
Restock requests that need shipped will only be sent FedEx Ground
Estimated Attendance
Estimated Students
Number of Class Periods
Please select...
1
2
3
4
5
6
7
8
9
Date Materials Needed
Date materials need to be ready for pickup, or date shipment needs to arrive
Instructions
Please specify whether materials are to be picked up or shipped. Please give full address and phone for shipping
Brochures
English
Spanish
African American
Filipino
Punjabi
Tissue
Volunteer
Posters - 11x17
Organ Posters
Tissue Posters
Spanish Posters
Vietnamese Posters
Do you need any Faith-based materials?
Yes
No
Faith-based materials
English
Pope Francis Prayer Cards
Guadalupe Prayer Cards
Caucasian Faith Hope Life Posters
Caucasian Faith Hope Life Bulletins
African American Faith Hope Life Posters
African American Faith Hope Life Bulletins
Spanish
Pope Francis Prayer Cards
Guadalupe Prayer Cards
Hispanic Faith Hope Life Posters
Hispanic Faith Hope Life Bulletins
Guadalupe Posters
Filipino
Filipino Faith Hope Life Posters
Filipino Faith Hope Life Bulletins
Punjabi
Punjabi Faith Hope Life Posters
Punjabi Faith Hope Life Bulletins
Registration Forms
English
Spanish
Chinese
Giveaways
Green Bracelets
English Pens
Spanish Pens
Window Clings
Hand Sanitizers
Earphones
Balloons (blue and green)
Educator Resource Guides (for teachers)
Other
Please indicate any special off list items here on separate lines
Premium Giveaways -
only for student participation -
limited quantities
DL Ball Caps
Carabiners
Stress Balls
Do you need an appreciation gift for your teacher?
Yes
No
Do you need an appreciation gift for your Point of Contact?
Yes
No
how many teachers?
how many contacts?
Appreciation Gifts
Grocery Totes
Carabiners
Stress Balls
Car Magnets
English Water Bottles
Spanish Water Bottles
DL Ball Caps
Premium Giveaways - limited quantities - only for registrations/call to action
Grocery Totes
Carabiners
Stress Balls
Car Magnets
English Water Bottles
Spanish Water Bottles
DL Ball Caps
Lanyards
Fit Strong Donor Recipe Cards
ITEMS BELOW MUST BE RETURNED AFTER EVENT
Please note: we will try to accommodate your banner preferences but may need to substitute due to availability.
Is your event indoors or outside?
Please select...
Inside
Outside
Clip Boards
English Tablecloths
Spanish Tablecloths
Brochure Holders
English Vertical Banners
Please select...
Caucasian
Hispanic
African American
Filipino
Mixed Race
Spanish Vertical Banners
Please select...
Hispanic
Portable 4 ft table with 2 chairs
English Tabletop Banners
Please select...
Caucasian
Hispanic
African American
Filipino
Mixed Race
Spanish Tabletop Banners
Please select...
Hispanic
Other
Contact Information