Community Education Program
Please make sure to fill in everything that applies and submit at least 2 weeks before your event. If your event is in less than 2 weeks, we may not be able to accommodate your request.
Event Date *
MM
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DD
/
YYYY
Agency or Community Partner *
Event Name *
Contact Person *
Email *
Phone # *
Setup time *
Time
:
Start Time *
Time
:
Event Duration *
Hrs
:
Min
:
Sec
Expected # of Participants *
Event location and directions (please include address and cross streets): *
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