American Red Cross Community Events Request Form
Organization Name:
*
Type of Organization:
*
Business/Corporate
Faith-based
Nonprofit
Education
Government
Other
Military/Veteran
If other, please explain
Name of Contact Person:
*
First Name
Last Name
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Email
*
example@example.com
If Referred by a Red Cross Representative, who?
First Name
Last Name
Type of Event (check all that apply):
*
Health
Safety
Community
Conference/Expo
Disaster Preparedness
Fair
Festival
Speaking Engagement
Other
If other, please explain
Date of Event:
*
-
Month
-
Day
Year
Date
Event Name:
*
Event Address:
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Arrival time (set-up):
*
Arrival time (set-up):
*
Hour Minutes
AM
PM
AM/PM Option
Event Start Time:
*
Hour Minutes
AM
PM
AM/PM Option
Event End Time:
*
Hour Minutes
AM
PM
AM/PM Option
Type of Location:
*
Indoor
Outdoor
Other
If other, please explain
Special Needs/Requests:
Event Audience:
*
Children ages 5-13
Youth ages 14-17
Families
Seniors
Business/Corporate
Faith-based
Immigrant/Refugee
Military/Veteran
Other
If other, please explain
Estimated Attendance:
*
5-50
50-100
100-200
200+
Which of the following materials will be provided by your organization?
*
Tent or other covered space
Table
Chairs
Refreshments/Snack
Full Lunch
Not Applicable
Other
If other, please explain
What do you want Red Cross to provide?
*
Informational materials/handouts
Guest speaker
Giveaways/Red Cross branded prizes
Trainings
Other
If other, please explain
Trainings, please list type of training:
If there are fees required to attend this event, how much?
Submit
Should be Empty: