Sun Safety Materials Order Form

For California-based Organizations and Residents Only

Check which Sun Safety Kit/information you would like to receive

Does your school/organization have a sun safety policy/curriculum?     Yes   No
School-based Kits
Early Education for Pre-School/Childcare Settings	Elementary Grades 1-2
Elementary Grades 3-4	Elementary Grades 5-6
Policy Development
Outdoor Worker Kits
Construction Workers	Parks & Recreation Facilities
Other: amusement parks, water parks, pools, etc.
Additional copies of materials provided in kits:
• Videos
"Hot Shots" DVD (Early Education Kit)	"Sun Show I" (ages 6-8/Grade 1-2 & 3-4 kits)
"Sun Show II" (ages 9-12/Grade 3-4 & 5-6 kits)	Construction Worker Ads
• Posters
"Alex the Alligator" (Early Education Kit)	Construction Workers
Grade 1-3	Parks & Recreation
Grade 4-6	General Tips
Other Materials
"Surfers-Block Those Harmful UV Rays" Booklet
Depending on which kit/materials you are requesting please enter the number of people that will be reached
School-based kits
Early Education	Elementary Grades 1-2
Elementary Grades 3-4	Elementary Grades 5-6
Policy Development (# of schools)
Outdoor kits
Number of staff/employees
If multiple materials or kits are needed, please state here how many and the purpose for additional materials: You have 500 characters remaining...
First Name
Last Name
Title
Organization/Business
Mailing Address
City
Zip Code
Telephone
Fax
E-mail

For fax or mail orders, use the attached form.

Sun Safety Materials Order Form

Send order form to
Fax: 916-779-2608
California Skin Cancer Prevention Program
1825 Bell St., Ste. 102
Sacramento, CA 95825

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