NMCIR Event Request Form
Please fill out this form to the best of your ability for an initial event request.
Email address *
Name *
Organization/School/Hospital Name *
Position *
Email *
Phone Number *
Address (where the event will take place) *
Proposed Dates & Times *
Focus of the Event (i.e., Executive Orders, Know Your Rights Training) *
Population (who will be attending; i.e., parents from PTA, advocates, health care practitioners, etc.) *
Number of attendees? There is no minimum. *
Please select your language of preference for the presentation. *
Required
Can you provide a projector, screen and laptop for the presentation? *
How did you hear about NMCIR?
Clear selection
Can we send you email notifications of future events? *
Thank you for contacting us!
NMCIR's goal is to serve everyone who sends us an event request. You should receive an email confirmation within 24 hours. If you don't, please email yestevez@nmcir.org.
A copy of your responses will be emailed to the address you provided.
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