HCAO Event Reporting Form
Please report details of all HCAO events so we can track our progress in doing outreach and education on universal healthcare in Oregon.
What type of event are you reporting? *
Required
Title of Event *
Your answer
Name of person reporting event *
Your answer
Event Contact or Person Reporting's E-mail *
Your answer
Group(s) organizing event *
Your answer
Speaker(s)/Presenter(s) *
Your answer
Date *
MM
/
DD
/
YYYY
Time *
Time
:
Location (Venue, city) *
Your answer
How many attended?
Your answer
Approximately how many new to HCAO?
Your answer
How many signed Statements of Support?
Your answer
Donations Collected?
Your answer
Swag Sales Total?
Your answer
Photos, videos or recording? - please send samples to mobilization@hcao.org
Notes on audience, responses, observations?
Your answer
Submit
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