BoomShake Street Action Requests
Name: *
Organization (if applicable):
Event Title: *
Event Date: *
MM
/
DD
/
YYYY
Event Time: *
Time
:
Time Range of BoomShake participation: *
Time
:
Location Name & Complete Address of Event: *
Event Link (website, FB event link, IG post, etc)
Email address: *
Day of contact phone number: *
Best way/time to contact you: *
Tell us a bit about yourself/organization: *
What community(ies) is your event for? *
What community(ies) are leading and organizing this event? *
Action Type *
What do you want BoomShake to do at the action? *
How did you hear about us? *
Are you/your organization able to make a donation or monetary offering? Either way is fine - it won't affect our decision :)
Clear selection
Anything Else? (Questions, Dreams, etc...)
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