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.

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First and Last Name *
Email *
Phone Number *
Leadership Title *
Chapter/Division Name *
Event Confirmed? *
Event City *
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.
Are you hosting an event in collaboration with another chapter? *
If YES, please list the name of the chapter.
Anticipated UN Day Event Date *
MM
/
DD
/
YYYY
Anticipated Event Venue *
Will your event reflect this year's theme of "Our Planet. Our Future" *
If YES, what climate related topic(s) will you discuss?
Confirmed event description *
Event or Registration Link
Anticipated number of attendees *
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