Red Cross of Southern Arizona: Survey - Fairs and Presentations Request

Fairs and Presentations Request

Occasionally, we staff tables at health fairs or make presentations to various groups on behalf of the American Red Cross. Would you like Red Cross to be at your upcoming event? Please fill out our request form and we'll reply as soon as possible. Please allow two weeks lead time before your event. Thank you.

Requestor/Presenting Organization Information

Contact Information


	Title:
*	First Name: Required
*	Last Name: Required
*	Email: Required
	Street 1:
	Street 2:
	City:
*	ZIP / Postal Code: Required
*	Phone Number: Required
	Yes, I would like to receive e-mail from American Red Cross Southern Arizona Chapter

Question - Not Required - Type of Organization

	Business/Corporation
	Educational
	Faith-based
	Foundation/Granting Organization
	Government
	Other Not-for-Profit/Social Service Agency

Event Date and Location

*

Question - Required - Date of Event

Month

Day

Year

Question - Not Required - Inclusive Dates (if more than one day)

(Maximum response 255 chars, approx. 5 rows of text)

*

Question - Required - Start Time

*

Question - Required - End Time

*

Question - Required - Event Location Name

*

Question - Required - Street Address

Question - Not Required - Building/Room Name/Number

*

Question - Required - City

*

Question - Required - Zip Code

Event Description

*

Question - Required - Event Title

*

Question - Required - What is the major focus of your event?

	Business Continuity Planning
	Career Orientation
	Disaster Preparedness/Response
	Health Awareness
	Safety/Emergency Preparedness
	Volunteerism
	Other

Question - Not Required - If Other, please list:

*

Question - Required - Event occurrence

	One-time/Non-recurring
	Monthly
	Quarterly
	Bi-annual
	Annual
	A First-time event with plans for future dates

Please note, a separate Event Request is required for non-consecutive days or for events that take place monthly, quarterly, bi-annually or annually.

*

Question - Required - Please provide a narrative description of event. (Please note: we cannot provide First Aid services.)

Event Set Up

*

Question - Required - Is this event indoors or outside?

	Indoors
	Outside

*

Question - Required - Equipment supplied by requesting organization

	6-Foot Table No Cloth
	6-Foot Table With Cloth
	8-Foot Table No Cloth
	8-Foot Table With Cloth
	Chairs
	Access to Electrical Power
	Booth
	Tent
	None

Question - Not Required - If Booth or Tent is provided, please indicate dimensions

*

Question - Required - To set up, the Red Cross may arrive before the event

	8 hours
	6 hours
	4 hours
	3 hours
	2 hours
	1 hour

*

Question - Required - Is free parking available for Red Cross participants

	Yes
	No

Materials, Displays & Vehicles
We will review your materials and vehicle request and work with you to determine your needs if we are able to participate in your event. In the event of a disaster, an Emergency Response Vehicle will not available.

*

Question - Required - Please check what you would like the Red Cross to supply

	Be Red Cross Ready Brochures
	Emergency Planning Information
	CPR/First Aid Information
	Disaster Preparedness Information
	Donation Information
	Water Safety Information
	Volunteer Information
	Table-Top Display (6-foot)

*

Question - Required - May we sell Red Cross products at your event?

	Yes
	No

Participant/Attendee/Audience Description

*

Question - Required - Estimated Number of Attendees

*

Question - Required - Event is for (check all that apply)

	Public
	Employees/Staff/Students
	Invited Guests/Other

*

Question - Required - Primary Demographic

	Youth
	Teen
	Young Adult
	Adult
	Senior

Question - Not Required - Number of other organizations participating

Advertising
The American Red Cross Southern Arizona Chapter may post information about this event on its Website or in internal newsletters, and may request a logo from your organization. Additionally, we may request to partner with you on media releases.

Question - Not Required - Web site address where event information will be listed

*

Question - Required - Will this event be posted on your Website or partner Website?

*

Question - Required - Will you be advertising this event with local media?

*

Question - Required - I would like to request a Red Cross logo to use in advertising

Question - Not Required - Public Affairs/Media Contact Name

Question - Not Required - Public Affairs/Media Contact E-mail

Question - Not Required - Public Affairs/Media Contact Phone Number

Question - Not Required - Major Sponsor/s of Event

Contact Person Day of Event

*

Question - Required - Full Name

*

Question - Required - Title:

*

Question - Required - Phone Number

Question - Not Required - Other comments