Sex Ed Kits: Request Form

Not-for-profit organizations, schools, government agencies, and community event organizers within Planned Parenthood Mar Monte's (PPMM) 42-county service area can request Sex Ed (Outreach) Kits. These kits are designed to be distributed directly to youth and adults, promoting sexual health and education.

Instructions

Complete the form below to request FY25 kits based on the population you aim to serve:

Middle School & Younger Teen Kit: 300 Pamphlets
High School & Young Adult Kit: 150 Pamphlets+100 Condoms+100 Lube Packs
Parents & Adults Kit: 150 Pamphlets+100 Condoms
Period Kits: 500 tampons/pads + 100 info cards

Delivery Information

Kits are shipped out on the fourth Tuesday of each Month. Expect to receive your kit within 30 days of submitting this form.

Note: Requests are fulfilled based on availability and shipped at no cost. The kits may not include all the items or brands pictured. Thank you for your interest in promoting sexual health education within your community!

Contact Information

Organization Name

Website

If none, put N/A

Total # of INDIVIDUALS your org serves annually

Please make your best estimate or use count from the most recent annual report.

PPMM County

Select from the drop-down or choose 'other' from list and write in

Phone #: (000-000-000)

This is used in case we have questions about your request.

Phone

Shipping Information

First Name

Last Name

Street Address

City

State

Zip Code

Who Will Receive Kits?

Data requested helps PPMM Education assess the populations reached through kits distributed by community partners.

Please provide % estimates below:

Please choose ONE primary setting where the kits/materials will be distributed.

AGE group:

Select the ONE age group representing most individuals you will serve with PPMM Kits.

% of individuals who live at or below 200% of the Federal Poverty Level:

Schools may provide % of students eligible for Free & Reduced Lunch at your site.

% who speak a language OTHER than English in their home

% identify as AAPI/Asian American

East Asian, South Asian, Southeast Asian, Pacific Islander or another Asian background.

% identify as American Indian/NATIVE AMERICAN

Alaskan Native, other INDIGENOUS

% identify as BLACK or African American

% identify as LATINe/o/a/x or Hispanic

% identify as Middle Eastern/North African:

% identify as WHITE

White American, Caucasian

% identify as MULTI-RACIAL

Sex Ed Kits

Please select the kits you'd like to receive:

Select language(s) for outreach kit materials

Feedback

What other languages should materials be offered in by PPMM to better serve your community?

The number of outreach items you AGREE to distribute from your kit by 06/30/25.

This is required for PPMM impact tracking. Kits include:

Middle School & Younger Teen Kit: 300 Pamphlets
High School & Young Adult Kit: 150 Pamphlets+100 Condoms+100 Lube Packs
Parents & Adults Kit: 150 Pamphlets+100 Condoms
Period Kits: 500 tampons/pads + 100 info cards

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