NMCIR Event Request Form
Please fill out this form to the best of your ability for an initial event request.
Email address
Name
Your answer
Organization/School/Hospital Name
Your answer
Position
Your answer
Email
Your answer
Phone Number
Your answer
Address (where the event will take place)
Your answer
Proposed Dates & Times
Your answer
Focus of the Event (i.e., Executive Orders, Know Your Rights Training)
Your answer
Population (who will be attending; i.e., parents from PTA, advocates, health care practitioners, etc.)
Your answer
Number of attendees (we don't have a minimum)
Your answer
Can you provide a projector, screen and laptop for the presentation?
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 mgarcia@nmcir.org.
A copy of your responses will be emailed to the address you provided.
Please complete the captcha before submitting the form.
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