UVideo Challenge Materials Order Form

Contact Information (All Required)

First Name:
Last Name:
Position/Title:
School/Organization:
Shipping Address:
City:
State:
Zip:
Phone (where you may be reached during normal business hours):
Email:

Materials

Please send me:

Introductory Challenge Packet (Limit ONE per school building / youth organization). This packet includes:
- Poster: "The Truth About Tanning" Infographic (approx. 15" x 30")
- Teens, Tanning and Melanoma Fact Sheet
- UVideo Challenge Information for Promoters (School Personnel and Youth Group Leaders)

Send me the Introductory Challenge Packet

Additional Materials [limit 5 per item]

Teens, Tanning and Melanoma Fact Sheet
UVideo Challenge Information for Promoters (School Personnel and Youth Group Leaders)

Comments/Questions:

How did you hear about the competition?

The information collected on this form will be used to mail the UVideo Challenge promotional materials that you request. By submitting this order, you agree to allow the Minnesota Department of Health to contact you regarding Challenge promotion. Your information will not be used for any purpose other than communications regarding the UVideo Challenge. You are not required to provide the data requested on this form. However, if you do not provide the data, the Minnesota Department of Health might not be able to provide you the materials requested.