African Community Educational Materials Printing Request Form

1.What is the name of your organization?
2.What is your organization's address?
3.How many English flip charts would you like to request? (If none, please write 0.) English flip charts can be viewed at https://www.hepb.org/assets/Uploads/Hepatitis-B-Flipchart-for-Community-Education.pdf
4.How many Amharic flip charts would you like to request? (If none, please write 0.) Amharic flip charts can be viewed at https://www.hepb.org/assets/Uploads/Amharic-Translation-FINAL-FLIPCHART-COPY.pdf
5.How many Arabic flip charts would you like to request? (If none, please write 0.) Arabic flip charts can be viewed at https://www.hepb.org/assets/Uploads/Arabic-Translation-FINAL-FLIPCHART.pdf
6.How many French flip charts would you like to request? (If none, please write 0.) French flip charts can be viewed at https://www.hepb.org/assets/Uploads/French-Translation-FINAL-FLIPCHART.pdf
7.How many Swahili flip charts would you like to request? (If none, please write 0.) Swahili flip charts can be viewed at https://www.hepb.org/assets/Uploads/Swahili-Translation-Final-Flipchart.pdf
8.How many copies of the resource Locating Hepatitis B Testing Resources (available only in English) would you like to request? (If none, please write 0.)
9.How many copies of the resource Using the Hepatitis B Flipchart for Community Education (available only in English) would you like to request? (if none, please write 0.)
10.How many copies of the resource Printable Hepatitis B Takeaway Card (available in English, Swahili, French, Arabic, and Amharic) would you like to request? (Please indicate your preferred languages. If none, please write 0.)
Current Progress,
0 of 10 answered