Event Request Form

Thank you for thinking of us for your event! This form is designed to gather information on any event request through which you would like to engage Morehouse School of Medicine (MSM) with your community or neighborhood residents. Please submit this form at least 8 weeks prior to your event to allow us the best possibility in assisting you. Please give us 5 business days to respond.

All questions with an * are required.

Event Info

Name of your Event:

Event Flyer

If available, upload your event flyer here.

Drop your files here

Event Date:

If there are multiple dates for this event, please fill out a separate form for each date.

mm/dd/yyyy

Start Time:

End Time:

Earliest Arrival/Set-Up Time:

Event Location:

For example, International Plaza. If virtual, please provide the meeting link if available.

Street Address #1:

If, virtual, write NA.

Street Address #2:

City:

If, virtual, write NA.

State:

Zip Code:

If virtual, write, NA.

How many people are you expecting to attend your event?

Description of the Event:

Briefly describe the theme, details, and goals of your event. Also, include what your expectations from MSM are (for ex. if you would like a speaker, let us know what kind of lesson you want the community members to take away) so that we can ensure the best outcome for your event!

Will the event be held outdoors or indoors?

Outdoors

Indoors

Both

Not sure yet

Will free parking be available?

Yes

To be determined

Please describe where parking is available.

Please describe where we can unload our vehicles.

Are restrooms available for volunteers?

This is an indoor event and restrooms are available.

This is an outdoor event and restrooms are available inside a building.

This is an outdoor event and restrooms are available via port-a-potty.

Restrooms are available both inside and outside of the building.

Restrooms will not be available.

Your Organization's Info

Organization Name:

Organization's Street Address #1:

Street Address #2:

City:

State:

Zip Code

Name of Contact:

Phone Number:

Phone

Alternative Phone Number:

Phone

Fax Number:

Phone

E-Mail:

Organization Website:

Who can we contact/check in with during the event?

Please leave blank if check in person is the same as "Name of Contact".

From Morehouse

What can we do for your event?

Thank you so much for taking the time to fill out our form! For the last question, we would like to ask you if you would like to join our list serv for MSM updates, events, information, etc.

Yes

Send me a copy of my responses

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