Signature Campaign Box Request
School Name
First Name
Last Name
Email
Phone Number
Is there currently an OMM club/program at your school?
Yes
No
No, but interested in starting!
Club Role
Please select...
Student Leader
Club Sponsor
OMM Staff
Other
Role at School
Please select...
Student
Educator
Mental Health Professional
OMM Staff
Other
Campaign Dates
Because You Matter: September 1 - November 15
We Belong Week: December 1 - February 15
Speak Up, Act Louder: March 1 - May 15
I want to host and receive supplies for...
When do you plan to host this campaign
Boxes are mailed weekly on Wednesday
Would you like to schedule a 15-minute video call to get planning support from OMM?
Yes
No
Do you need the campaign assets translated into Spanish?
Yes
No
Spanish digital assets will sent on October. 1
Any other questions for us?