CHHC MMU Interest Form
Please fill out the following information in order to have a MMU Event at your church or place of business. Please note that while we are asking for a sponsorship of the MMU, we will come to your event even without a sponsorship. 

Requests for the MMU should be made 3-4 weeks in advance.

*Note: Not all spaces are made the same, so there are a number of factors that may not make an MMU Event feasible.

Any questions for MMU events can be directed to Yareima "Carmen" Valecillos at mmu@communityofhopeclinic.com.
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Email *
Name of Individual/Organization/Church requesting an MMU Event *
Contact Name *
Contact Phone *
Contact Email *
Address of Organization *
What is the name of the event? *
Event Address *
When is the event? *
MM
/
DD
/
YYYY
What time is the event? *
Time
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