ACON PLAYPACK REQUEST FORM

Name*

First NameLast Name
Email*

Confirmation Emailexample@example.com
Address*

Street Address

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CityState

Postcode
PLAYPACK OPTIONS

Ending HIV PACK:

- 20 Durex Condoms
- 20 Water based lube sachets
- A bottle of Silicone lube
- 4 Gloves
- Rubber Cockring
- PEP, PrEP, UVL and Testing Info

LGBTQ+ PACK (Latex-Free):
- 10 Latex-free Condoms
- A bottle of Natural water-based lube
- 10 Gloves
- Viraclean toy cleaner
- Toy maintenance brochure
- PEP, PrEP, UVL and Testing Info

BULK Condom Order Request:

• Play (Sex) Party
- Up to 25 attendees: Approx. 75 condoms and lube sachets
- Up to 50 attendees: Approx. 150 condoms and lube sachets

• Social, Community, and Educational Event
- Safe Sex Packs (each containing 2 condoms & 2 lube sachets) printed educational resources upon request.
Please specify the number of Safe Sex Packs needed in the comments.

• Need more?

Add a comment in your request, and we’ll get in touch!
Note: Play (Sex) Parties refer to private gatherings such as sex parties and similar social events. Orders are not for resale or commercial use.
Please select your preferred PLAYPACK*

Ending HIV PACKLGBTQ+ PACK (10 Latex free condoms and gloves)Bulk Condoms & Lubes for Play Parties(25)Bulk Condoms & Lubes for Play Parties(50)Bulk for Social, Community, and Educational EventOther
Please tell us more about your event and numbers of attendees *
- Date, Location, Approximate number of attendance, What type of people are attending etc.
Anything else you would like to tell us?
Verification

We require a mobile number for verification purposes. Please enter your mobile number to receive the verification code. For bulk resource requests, we may call this number to request additional information about your event.
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Acknowledgement*

I confirm that I am ordering this pack for my own personal use
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