3. Outreach 1: Event Submission

Event Basics

Limited to 50 characters
0 of 280 max characters
Type of Event (Choose all that apply)

Event Date and Time

Due to the volume of submissions, your event must be at least 30 DAYS from today to submit.

Start Time
End Time
Vendor Setup Time

Event Location

Sponsoring Organization Information

Type of Sponsor

Event Audience and Participation

Is this event open to the public?
0 of 280 max characters
Expected Attendance
0 of 280 max characters

DOH Participation Details

Does DOH have to submit a registration form to attend the event?
Will the DOH be charged a fee to attend?
Are Tables and Chairs Provided?
Is event in a smoke-free and vape-free environment?

Promotion and Public Listing Information

Do you have an image to accompany this event post?

Maximum file size: 10MB

Do you want this event added to our public events page at AAHealth.org/events?

DOH Programs/Services/Information Requested

Select the Department of Health (DOH) programs or services you would like to have at your event.

Please Note: All requests are subject to staff and space availability.

Behavioral Health (Check all that apply.)
Diseases and Immunizations (Check all that apply.)
Environmental Health (Check all that apply.)
Infant, Children and Adolescent Services (Check all that apply.)

Primary Contact Information

Your Name
Your Name
First
Last
Mailing Address *
Mailing Address
City
State
Zip/Postal

Additional Information (Optional)

This section is for any further details you wish to provide that haven't been covered.

Outreach Editor Only

Publish Status

Admin Only

Submit This Event