• Facebook
  • Twitter
  • YouTube
  • Instagram
  • Google+
  • Pinterest
Toggle Menu

Educational Material Request Form (payment)


Komen North Carolina Triangle to the Coast gets many requests for educational material; unfortunately, we can not fill all requests. Only requests from individuals or organizations in our service area can be considered. Our Affiliate service area covers 29 counties including: Bladen, Brunswick, Caswell, Chatham, Columbus, Duplin, Durham, Edgecombe, Franklin, Granville, Halifax, Harnett, Johnston, Lee, Moore, Nash, New Hanover, Northampton, Onslow, Orange, Pender, Person, Pitt, Sampson, Scotland, Vance, Warren, Wake, and Wilson.

• Please give at least two weeks lead time for your request or you may not receive materials.

• There is a limit of 25 copies of each item and a max of 75 copies total.

We do our best to fill all requests for material and will give prompt notification if we cannot. For more information, please contact info@komennctc.org.

If you are looking for pink ribbons, bracelets, or other branding items you may order them online from Shop Komen where 25% of your purchase price will be donated to Susan G. Komen North Carolina Triangle to the Coast.

1. Contact Information














Question - Required - Date of Event:





Question - Required - Please select the material you would like from the options below. You are only able to select 3 options and will be provided 25 copies of each option totaling to a max of 75 copies.
Please make between 1 and 3 selections from the choices below.




Participant Information:

Question - Required - Age range of participants (check all that apply):
Please make at least 1 selection from the choices below.

Question - Required - Primary audience (check all that apply):
Please make at least 1 selection from the choices below.


   Please leave this field empty