![]() |
Request for HEAT® Info Complete the form below to request HEAT® materials. (Use TAB to move throughout the form.) |
If you would prefer to request HEAT® materials via fax or mail, complete the form, print, and send to: Nina Hier HEAT® Program PO Box 33617 Detroit, MI 48232 Fax: 734.464.0009 Phone: 734.464.1100 x 227 E-mail: nhier@maipf.org |
| Name | |
| Title | |
| Address 1 | We send UPS - No P.O. Boxes please |
| Address 2 | |
| City | |
| State | |
| Zip Code | |
| Phone (with a/c) | |
| Fax (with a/c) | |
| Required for confirmation page to print. | |
| Comments |