Community Tool Box Curriculum Order Form

Item QuantityParticipant Guides ($12 each) QuantitySet of all 14 Participant Guides ($150 each) QuantityFacilitator’s Kits ($50 each)* Total Cost

1. Creating and Maintaining Coalitions and Partnerships 2. Assessing Community Needs and Resources 3. Analyzing Problems and Goals 4. Developing a Framework or Model of Change 5. Developing Strategic and Action Plans 6. Building Leadership 7. Developing an Intervention 8. Increasing Participation and Membership 9. Enhancing Cultural Competence 10. Advocating for Change 11. Influencing Policy Development 12. Evaluating the Initiative 13. Implementing a Social Marketing Campaign 14. Writing a Grant Application for Funding 15. Improving Organizational Management and Development 16. Sustaining the Project or Initiative SUBTOTAL: Shipping will be added to the subtotal. Please circle: Overnight 1 Class

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Name: Email: Phone: Mailing address:

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TOTAL (Work Group will complete this Total):

*NOTE: The Facilitator’s Kit (adaptable instructor/facilitator’s outline, adaptable PowerPoint slides, and a copy of the Participant Guide) is available for those who order a minimum of 10 copies of the Participant Guide for a Module. If 20 or more copies of a Module are ordered, the Facilitator’s Kit for that Module is included for free. You may submit your order via email, fax, or by phone. EMAIL:, FAX: (785) 864-5281, PHONE: (785) 864-0533

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