Community Outreach
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What are you looking for MMC to provide?
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Outreach Booth
Short Presentation (less than 20 minutes)
Long Presentation (20 minutes or more)
Panel Discussion
Brochures only
Submitted By
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Date
Event Date
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Year
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Event Time
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AM/PM Option
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Organization
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Event/Presentation Name
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Location
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Address
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Address
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Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Event Contact Person
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Title
Phone
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Email
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Details about the Audience
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Expected # of Attendees
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Languages
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English
Spanish
Length of Presentation
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Theme of Presentation
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MMC Services - General Introduction
DV 101 - How to Identify Domestic Violence
Healthy Relationships
Domestic Violence Effects on Children
Human Trafficking
Teen Dating Violence
Will you have a computer, recent version of PowerPoint program, projector, clicker, and sound capabilities for this presentation?
Yes
No
Brochures Requested
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DV 101 One Sheet, English/Spanish
Legal Services Brochure, English
Counseling Services Brochure, English
Safe Housing Services Brochure, English
Education Services, English
Wish List, English
Latest Printed Newsletter, English
Amount of Brochures Requested
Please choose a date you would like your request fulfilled by. (Allow a minimum of 3 business days)
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Month
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Day
Year
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Will a table, two chairs, and canopy be provided?
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Yes
No
Other Comments
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