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GLACVCD Event Participation Request
Please complete the form below to request the Greater Los Angeles County Vector Control District to participate in your community, organization, or partner service event.
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* Indicates required question
Event Name
*
Your answer
Event Type
*
Meeting Request
City / County / State Agency or Legislator Presentation
Business / Organization Staff Training: Mosquito Safety
Community / General Education Presentation
Community Event / Informational Booth
Mosquito Literature Request
Media Interview Request
Other:
Event Format
*
In-Person Event
Virtual Event
Event Location (Physical Address or URL)
*
Please include the street address and zipcode of an in-person event, or the full web address of a virtual event
Your answer
Event Date
*
MM
/
DD
/
YYYY
Event Start Time
*
Time
:
AM
PM
Event End Time
*
Time
:
AM
PM
Estimated Event Size
*
Below 30 attendees
Between 30 and 50 attendees
Between 50 and 100 attendees
Between 100 and 250 attendees
Between 250 and 500 attendees
More than 500 attendees
GLACVCD Event Personnel Request (check all that apply)
Leadership Representatives (General Manager, Directors, Managers)
Public Outreach Representatives (Public Information Officer, Community Liaison)
Education Program Representatives
Other:
GLACVCD Event Materials Request (check all that apply)
*
Potential Mosquito Sources In Your Home Handout
Mosquitoes in our Communities Booklet
Invasive Aedes Mosquito Alert Booklet
Department of Public Health – Invasive Aedes Mosquito Control Checklist
West Nile Virus Brochure
Guide to Applying Insect Repellent Handout
Heartworm and Your Pets Handout
Mosquito Prevention and Protection Handout
District Brochure
Rain Barrels and Mosquitoes Flyer
Do-It-Yourself - How to Screen Yard Drains Handout
Flower Pots and Mosquitoes Flyer
Education Program Mobile Unit (Vehicle)
Other:
Required
Please indicate the quantity of materials you are requesting (
mosquito literature request only
)
Your answer
What Supplies / Equipment Are Included At Your Event? (Check All That Apply)
*
Tables
Table Cloths
Chairs
Power / Extension Cords
Electric Outlets
Refreshments
Canopy
Other:
Required
Event Details
*
Please describe your event in detail, including its purpose and why the GLACVCD will be a good fit
Your answer
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