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Health Fair/ Tabling

Please complete this form to request a Komen representative at your tabling or Health Fair event. For other volunteer and materials requests, please see corresponding tabs. We get many requests for events, and unfortunately we cannot fill all of these requests. We ask that you place your request as far in advance as possible as this increases the chance of volunteer availability for your event. To ensure your request is processed, please complete this form at least 4 weeks in advance.

 

Contact Information

  Contact Information

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Name:

 

 

   

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Event Details

 


   


   


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Question - Not Required - Event Date




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* Will event be located indoors or outdoors?
(Select one of the available choices or enter a different value.)



 


 


 

Event Participants

   


 
Question - Not Required - Audience Gender (check all that apply)

 
Question - Not Required - Audience Age Range (check all that apply)

 
Question - Not Required - Audience Demographics (check all that apply)

 
Question - Not Required - Will the attendees be: (check all that apply)

 


   Please leave this field empty