Outreach & Condom Distribution

"*" indicates required fields

Name of Contact Person Coordinating the Program

First Last

Phone

Address

Street Address City State ZIP Code

Parking Instructions

What vendor items are provided by the host?

Date and Time of the Event

Date*

Time

Number of expected participants with age and demographics of the audience.

Can we provide free & confidential HIV Testing at the event?

Yes

Can we distribute free condoms and lube, and other printed materials?

Yes

Name

This field is for validation purposes and should be left unchanged.

Condom Distribution

We can provide your business/campus with free condoms! Nashville CARES currently has over 20 locations in Middle TN where we provide this free service. We refill as needed and can also provide printed material for people that are interested in volunteering or taking advantage of one of our services. Contact us at 615-499-7502 if you have questions about your business becoming an official Condom Drop Location

"*" indicates required fields

Contact name*

First Last

Contact phone*

Contact email address*

Provide your physical address*

Street Address City State ZIP Code

What are your hours of operation?*

What is the location of where you would like to place the condoms and printed materials?*

Provide an estimate of many condoms you will need each month*

Provide us with the ages and demographics of your customers/patrons*

Comments

This field is for validation purposes and should be left unchanged.