Materials Order Form

Double Up and AZFMNP Materials Order Form

Please use this form to request printed postcards, high quality files for sharing, and/or digital promotional materials. If you need assistance or have any questions, please email Kaylie Langtry at [email protected]. Thank you for your support.

About You

Name(Required)

First Last

Your organization name(Required)

Share your affiliation. If none, enter “self.”

Email(Required)

Phone(Required)

Mailing Address for Packages(Required)

Street Address Address Line 2 City State ZIP Code

Are you a WIC Agency?(Required)

WIC Agencies Only

WIC agency name(Required)

How many English WIC FMNP referral postcards would you like?

Please enter a number greater than or equal to 0.

Click here to see a sample in a new window.

How many Spanish WIC FMNP referral postcards would you like?

Click here to see a sample in a new window.

Which region do you need in your WIC postcards?(Required)

Do you want envelopes and stamps for every postcard you ordered?

Yes

No, I need fewer stamps

By default, you’ll receive the corresponding number of envelopes and postal stamps as postcards ordered. Check “Yes” if this is what you want.

Special Number of Stamps and Envelopes

Skip this question if you want the default 1:1:1 ratio of postcards:envelopes:stamps.

If you need a different amount of envelopes or postal stamps (for example, if some clients pick up their postcards in office and you don’t need to send them all by mail) please provide the numbers of envelopes and postal stamps to be included in your order.

Are you interested in Double Up Food Bucks Arizona promotional materials?(Required)

Double Up Food Bucks Arizona Promotional Material

Number of Double Up Postcards (4×6" double sided, English/Spanish):

Click here to see a sample in a new window.

Do you need Double Up postcards in additional languages?

If so, please specify here.

Number of Double Up Regional Flyers (8.5×11" double sided, English/Spanish):

Click here to see a sample in a new window.

Do you need Double Up flyers in additional languages?

If so, please specify here.

Which regional Double Up flyer do you need?(Required)

Are you interested in WIC and Senior AZFMNP promotional materials?(Required)

AZFMNP Material

Number of AZFMNP Regional Flyers

Click here to open sample in new window.

Do you need AZFMNP flyers in additional languages?

If so, please specify here.

Which region's map do you need in your AZFMNP Regional Flyer?(Required)

Are you a contracted AZFMNP partner?

NOTE: If you’re not operating an authorized site, please don’t order admin materials from this section. Email us if you have questions about this!

Number of 8.5×11" WIC / Senior FMNP Match Flyers

Click here to open sample in new window.

Do you need WIC / Senior FMNP Match flyers in additional languages?

If so, please specify here.

Farmers Markets only: Trifold brochure of eligible items for Double Up, AZFMNP and SNAP

Click here to open sample in new window.

Do you need Trifold Brochures in additional languages?

If so, please specify here.

Farmers Markets only: Number of 8.5×11" Cheat Sheet Laminated Card of eligible items for Double Up, AZFMNP and SNAP

Click here to open sample in new window.

Do you need Cheat Sheet Laminated cards in additional languages?

If so, please specify here.

Admin benefit issuance materials

Do you need admin benefit issuance materials?

Currency Orders

NOTE: If you’re not operating an authorized site, please don’t order admin materials from this section. Email us if you have questions about this!

SNAP Clip-on Flag Signage (for vendors)

Please enter a number from 0 to 100.

Click here to see sample in new window.

Double Up Clip-on Flag Signage (for farmers only)

Please enter a number from 0 to 100.

Click here to see sample in new window.

Number of Double Up Food Bucks silver $1 tokens

Number of WIC FMNP coupons – increments of 50

Please enter a number greater than or equal to 0.

NOTE: ability to fulfill this request will depend on your contracted caseload

Number of Senior FMNP coupons- increments of 50

Please enter a number greater than or equal to 0.

NOTE: ability to fulfill this request will depend on your contracted caseload

Number of Match FMNP coupons – increments of 50

Please enter a number greater than or equal to 0.

NOTE: ability to fulfill this request will depend on your contracted caseload

Number of Double Up token bags – increments of 100

Please enter a number greater than or equal to 0.

Color: Green Size: 3×4″

Number of Double Up token counters

Please enter a number greater than or equal to 0.

Limit 1 per site

DOUBLE UP ARIZONA

DOUBLE UP ARIZONA