INSTRUCTIONS: Please put the publications you are requesting in numerical order by the publication number. Washington State Department of Health Division of Environmental Public Health Zoonotic Disease – Program PUBLICATIONS REQUEST NOTE: This is your Shipping Label Use complete street address (UPS does – not deliver to a P.O. Box). Telephone Date Name/Requestor Name of Organization E-mail Address Shipping Address City State Zip This order form is only for Division of Environmental Public Health publications. Back Publication Quantity Title Number Requested Mosquito Problems Start at Home Poster – 1 333-049 (English) Do You Know What’s Biting You? Flyer – 2 333-053 (English) Do You Know What’s Biting You? Flyer – 3 333-053 SP (Spanish) Repellent: Choose It. Use It. Bookmark – 4 333-170 (English) 5 6 7 8 9 10 Include publication number, title, and quantity. Your order will be filled to the nearest packaged amount. (Allow weeks for your order to arrive). Requestor’s name and phone number must be filled in (in case we have questions about your order). You may orders by sending this completed form in one of three ways: Email: anne.duffy@doh.wa.gov Fax: 360-236-2261 Mail: ATTN Anne - Zoonotic Disease Program Washington Department of Health PO Box 47825 FOR OFFICE USE ONLY Olympia, WA 98504-7825 If you have any questions, please contact the Anne Duffy of the Account Number Date Received Zoonotic Disease Program at 360-236-3372.
Washington State Department of Health Division of Environmental Public Health – Zoonotic Disease Program PUBLICATIONS REQUEST NOTE: This is your Shipping Label – Use complete street address (UPS does not deliver to a P.O. Box). Name/Requestor Telephone Date Name of Organization E-mail Address Shipping Address City State Zip This order form is only for Division of Environmental Public Health publications. Publication Number Title Quantity Requested Back 1 333-049 Mosquito Problems Start at Home – Poster (English) 2 333-053 Do You Know What’s Biting You? – Flyer (English) 3 333-053 SP Do You Know What’s Biting You? – Flyer (Spanish) 4 333-170 Repellent: Choose It. Use It. – Bookmark (English) 5 6 7 8 9 10 INSTRUCTIONS: Please put the publications you are requesting in numerical order by the publication number. Include publication number, title, and quantity. Your order will be filled to the nearest packaged amount. (Allow weeks for your order to arrive). Requestor’s name and phone number must be filled in (in case we have questions about your order). You may orders by sending this completed form in one of three ways: Email: anne.duffy@doh.wa.gov Fax: 360-236-2261 FOR OFFICE USE ONLY Account Number Date Received Mail: ATTN Anne - Zoonotic Disease Program Washington Department of Health PO Box 47825 Olympia, WA 98504-7825 If you have any questions, please contact the Anne Duffy of the Zoonotic Disease Program at 360-236-3372.
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