UNA-USA Chapter UN Day Event Form
SPEAKER REQUEST: The deadline passed to request a speaker for UN Day. Please just use this form to tell us about your event and/or request a UN Day Swag Kit.

Information will be uploaded to our website as is, so please avoid using all caps or only lower case letters unless that is how you wish it to appear on the website.
First and Last Name *
Your answer
Email *
Your answer
Phone Number *
Your answer
Leadership Title *
Your answer
Chapter/Division Name *
Your answer
Event Confirmed? *
Event City *
Your answer
Event State *
Mailing Address for UN Day Swag Kit (Street, City, State, Zip). Answer required to receive kit. Our vendor will start mailing kits around mid- to end of September.
Enter recipient name, street address, city, state, and zip for where you want your UN Day swag kit to be sent. Only one kit can be sent per chapter.
Your answer
Are you hosting an event in collaboration with another chapter? *
If YES, please list the name of the chapter.
Your answer
Anticipated UN Day Event Date *
MM
/
DD
/
YYYY
Anticipated Event Venue *
Your answer
Will your event reflect this year's theme of "Our Planet. Our Future" *
If YES, what climate related topic(s) will you discuss?
Your answer
Confirmed event description *
Your answer
Event or Registration Link
Your answer
Anticipated number of attendees *
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