Empowering Michigan's Youth to Make Informed Choices

By submitting this form, you are requesting a free or low-cost lock box. To process your request, we require your full name, the city, and your email address or phone number. Please indicate your preferred method of contact, either by text or email.

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Once you submit the form, the MYCAEA Coordinator will receive an automated notification and will contact you within a few days to arrange the delivery of your lock box. Delivery may be handled via mail or in-person, depending on your location and preferences.

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Please note that the information you provide will be used solely for the purpose of fulfilling your lock box request. Your data is secure and will not be shared with or sold to any third parties.