• Main Number (816) 561-0304
    Main Number (816) 561-0304
  • In-Home Care, KCMO (816) 777-0078
    In-Home Care, KCMO (816) 777-0078
  • Home Health Care, St. Joseph (816) 364-0900
    Home Health Care, St. Joseph (816) 364-0900

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Outreach Events Form

Resource Development and Outreach Events Request Form

Please complete this ONLINE form to submit your request for event materials to Lea Klepees.

Please submit this form at least 1 week before materials are needed. You will be notified when  materials are ready for pick up.

Please return items to the Resource Development Department within 24-48 hours of the completion of the event.

If you have any questions about submitting your project request, contact Lea Klepees.

Name of person submitting project.
Please select one.
Click field for "pop out calendar"

Date selected must be 5 business days or more from day of submission.

If your job cannot wait 5 business days, please write details in the "Additional Information" box below.

(Please note that 'ASAP' is not an acceptable delivery date.)

Click field for "pop out calendar"
(if applicable and beneficial to the project)
TWP Staff Assignment
Check one
TWP Promotional Items Request
Please choose all that apply. Add detail in comments field.
Use this area to list the literature you need.
Use this area to list the promotional items you would like.
Use this field to list other items you need or additional information that may be helpful.

PLEASE NOTE:  When you click the SUBMIT button below, you should automatically see a confirmation on-screen and have an email sent you.  If you do not get this, please scroll to the top of this submission to see if any areas have an error message that need corrected.