Request Printed ACTC Program, Department & Service Brochures

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* Requestor’s or Department’s Name

* Requestor’s or Department’s Email

Date needed by

* Location to send printed brochures when ready

* How many of program brochures selected above do you need? (25 of each program brochure comes in one full set)

What ACTC department or service brochures do you need?

ScholarshipsStudent Support ServicesWorkforce SolutionsWorkforce - Advanced Nursing AssistantWorkforce - CDL ProgramWorkforce - Phlebotomy for the Health Care WorkerWorkforce - Kentucky Medication AideWorkforce - State Registered Nurse AideOther (list department or service brochure name in the other section at the end of the form)

* How many department or service brochures selected above do you need?

Other request or comment not listed above

* What brochure rack locations, special events or other purposes will these brochures be used for?

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Faculty & Staff