PTPDE Event Request Form
This form requires you to provide basic event information that will be used to create an event flyer.
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Email *
Program Request Status *
If you are submitting this request for the first time, please select "Draft Only" option below. "Draft Only" requests will be reviewed at the program committee meeting and upon final approval, the Program request status can be changed to "Final". Upon changing of the status to "Final", the flyer design committee will use the information to design the flyer.
Event Title *
Event Subtitle (if there is one)
Event Description (3-5 sentences) Maximum 75 words *
Event date *
Event Start time *
Event End time *
Event Location *
Zoom event or physical location? Include Zoom event link etc here if you have it; if you need to use standard PTPDE zoom link, please state that you want to use the standard PTPDE zoom link. Please provide event address if the event takes place at a physical location. Default Zoom link shall be: Personal Meeting ID 577 517 7902
Are you planning to reach out to potential attendees other than PTPDE general membership and board members? How will you reach out to them?   *
Please describe if you plan to make connections with other organizations for increased attendance for this event.
About the speaker(s) (if applicable) Maximum 50 words
Flyer look and feel preference
If you like, you can provide sample event flyer to indicate how you envision the flyer to look like. If you don't have a specific preference for the look and feel of the flyer, you don't have to provide sample event flyer.
Photo of the Speaker(s) and Sample Event Flyer
After you have submitted this form, please send an email to with photo(s) of the speaker(s) and sample event flyer (if you already have one). Thank you.
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