Supply Request

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Supply Request

This is intended for Supply Requests only.

Lookup Requests can be submitted at https://forms.gle/BYLUeWaFTTuuMhtm7

1. What is your name? *

2. What is the best phone number to reach you at? (if we have questions) *

3. What state are you from? *

North Dakota

South Dakota

Nebraska

Kansas

4. Which item(s) do you need? (We will ask for a count later) *

UPS labels to the Lincoln Office

UPS labels to your Supervisor

Business Cards (if you need to update phone number, please provide in question 9 below)

Door Hangers (6 per sheet)

Blank Questionnaires (please specify survey in question 9 below)

Name Badge

Windshield Card (NAS-007)

Other:

Required

6. How many of the above item(s) would you like?

(Also, if multiple items were selected, please clarify how many of each here.)

7. If you choose UPS labels to the Lincoln Office or UPS labels to your Supervisor, would you like the labels mailed or emailed to you? (Emailed labels can be provided quicker but you will need to print.) What shipping speed would you like the provided labels?

Mail label(s) - Ground Delivery (2+ days)

Mail label(s) - Next Day Air (1 day)

Email label(s) - Ground Delivery (2+ Days)

Email label(s) - Next Day Air (1 day)

Clear selection

8. If you choose UPS labels to the Lincoln Office or UPS labels to your Supervisor, what is the in-package weight expected? (approximate lbs. and ozs.)

9. Is there any additional information that we should know? (e.g. Business cards updated phone number, an Alternative address to ship this request to, survey for Blank Questionnaires)

Submit

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