Men4Men Sexual Health Outreach Project (SHOP)

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  Order Form FREE condoms & lube  
FREE CONDOMS & LUBE for Men who have sex with other Men, based in LUTON

 

   

 

The information you provide below will be held in strict confidence, but is required to secure future funding that will enable this facility to continue. Orders will be dispatched in unmarked envelopes but only to postal addresses in the Luton Borough Council (UK) postal area.

Tick the boxes of the item(s) you require and ensure you complete all other fields or your order will not be processed. A maximum of 3 safer sex wallets are supplied per order (each contains 2 condoms and 2 sachets of water based lube).

 

Lube and Condom Supplies

Full Name  
Address Line 1:
(or company name)
 
Address Line 2:
(optional)
 
Town:  
Postcode:  

  (We accept postal addresses in the Luton Borough Council area only)

email:    
Phone Number:   
   
Age:    
Gender:    
Ethnic Origin:    
Sexuality:    
 

        Special Order Instructions:
         (optional - only complete if applicable)

 


NO - I do not wish for you to use my email address to contact me about other services and related projects which the Men4Men SHOP are involved with, that you think I would find of benefit.

(Please note: Under NO circumstances will your email address be passed on to any third party organisations)

 

Press the SUBMIT button once and allow up to
20 seconds for the order confirmation page to appear.

 

 

  

 
Cambridgeshire Community Services NHS Trust

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