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

If available, upload your event flyer here.

Drag and drop files here or

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

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

If, virtual, write NA.

If, virtual, write NA.

Select
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If virtual, write, NA.

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?*

If yes, please describe below. If no, please let us know if the event will cancelled.

Choose all that applies:

Though we are not requiring the exact number and size for the tents to be provided, if you are requesting screenings/vaccinations, clinical screenings will need four 10x10 tents, and for both vaccinations and screenings five 10x10 tents will be needed. Thank you.

Though we are not requiring the exact number of tables/chairs to be provided, if possible, screenings will need six 6ft tables and 16 chairs. If requesting both screenings and vaccination services, we would need seven 6ft tables and 28 chairs. Thank you.

Choose all that applies:

Will free parking be available?*

1) What is the rate per hour? 2) Is parking validation available? 3) Will the validation be for the entire day?

Are restrooms available for volunteers?*

Your Organization's Info

Select or enter value
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Phone
Phone
Phone

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

Phone

From Morehouse

What can we do for your event?

Select or enter value
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Let us know what kind of topic you'd like us to focus on.

Would you like a staff person to help attend?*

A staff person can help man a table or distribute MSM materials at 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.*
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