SRS Advocacy Calendar Event Request
Please provide information about your advocacy event. We will add your event to our socially Responsible Surgery Advocacy and Community Events public calendar and newsletter pending review by our advocacy team.
Email address *
Title of Event *
Your answer
Name of Organization or Individual Sponsoring Event *
Your answer
Contact Information for Event Organizers *
Your answer
Contact information of event organizers *
Your answer
Event Location *
Your answer
Event Date *
MM
/
DD
/
YYYY
Event Start Time *
Time
:
Event End Time *
Time
:
Event Details (e.g. registration/RSVP/web links) *
Your answer
Brief Summary of Event *
Your answer
Submit
Never submit passwords through Google Forms.
This form was created inside of Boston University. Report Abuse - Terms of Service