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Arkansas Can Do Committee - Believe Achieve Campaign
Order Form 

T-Shirts are available for $10.00 each.  Currently, two posters, a brochure and bookmark are available and are being offered free of charge.  Additional items will be added as they become available.  The posters may be picked up from any Can Do Committee member at no cost.  If you prefer, you may pay shipping and handling charges and have the items shipped to you.  Please specify the items you wish below and the number of copies requested.  We are tracking how the materials will be used and where they will be displayed.  We would appreciate it if you would include this information on the order form.  

Name __________________________________________________________________

Organization ____________________________________________________________

Address ________________________________________________________________

City_________________________________            State____                      ZIP _______

Telephone_________________    E-Mail Address _______________________________

Where do you plan to display materials?  ______________________________________

Method of Payment (No cash or credit cards please.)

Check or money order accepted.  Make payable to: DRC – Can Do Committee.

¨ Check Enclosed    

¨ Money Order Enclosed   

Mail a copy of this order form with your check or money order to:

Arkansas Can Do Committee

c/o Kris Baldwin

DHS, Division of Aging and Adult Services

P.O. Box 1437, Slot S530

Little Rock, AR  72203

For questions about your order or postal rates for large orders, please call Kris Baldwin at