Educational Materials Order Form

Limited quantities of educational materials are free of charge and donations are appreciated. For each item you need, specify the quantity in the spaces provided. Please allow up to three weeks for processing this order.

You may also download and fax or mail your order to us.

Description	English	Spanish
Stickers with Poison Hotline Number
Magnets with Poison Hotline Number		---
Poison Center Brochure
Poison Prevention Fact Sheet Set Ipecac Alert, Prevent Poisonings in Your Home, Poisonous Plants, Safe Plants, Children Act Fast So Do Poisons!
Poison Safety Word Search, Crossword Puzzle and Coloring Book Set*		---
New England Regional Poison Newsletters (bilingual)
Please call back for possible poison prevention presentation or additional materials

Contact Information (* required)
Name:	*
Title:
Agency:
Type of Agency:	*
Address:	*
Address 2:
City:	*
State:	*
Zip Code:	*
Phone:	*
Fax:
Email:	*