District of Ohio Event Submission Form

1

Brother's Name* This field is required.Please indicate the full name of the Brother who may answer any follow up questions about this form submission.

First Name

Last Name

2

Brother's Email Address* This field is required.Please indicate the email address of the Brother who may answer any follow up questions about this form submission.

example@example.com

3

Brother's Mobile Phone Number* This field is required.Please indicate the mobile phone number of the Brother who may answer any follow up questions about this form submission.

Area Code

Phone Number

4

Chapter(s) Hosting Event/Program* This field is required.Please indicate the Chapter(s) that is/are hosting this event/program.

You may make multiple selections by holding down the "Ctrl" or "Command" button.

5

Event/Program Category* This field is required.Please select the appropriate category for the event/program.

APhiA National Program

APhiA National Initiative

Chapter Program, Initiative, Special Project

6

Event/Program Intent* This field is required.Please indicate the intent of the event/program. Please check all that apply.

Community Activism/Awareness

Youth Development

Fundraiser

Social

7

Event/Program Target Audience* This field is required.

Brothers Only

Open to Public (ie., event attendees will include persons who are not members of the Fraternity)

Type option 3

Type option 4

8

Event/Program Name* This field is required.

9

Event/ Program Date* This field is required.

Date

10

Event/Program Time Frame (ie., Start and End Time)* This field is required.Please indicate the time that the event/program begins ... and the time that the event/program ends.

Hour

Minutes

Until

Hour

Minutes

11

Event/Program Venue * This field is required.Please indicate the name of the venue where the event/program will be hosted.

12

Event/Program Venue Address* This field is required.Please indicate the address of the venue where the event/program will be hosted.

Street Address

Street Address Line 2

City

State / Province

Postal / Zip Code

Country

13

Event/Program Cost of Attendance * This field is required.Please indicate the cost of attendance (if any) for this program/event. If the event is Free, please select "0"

14

Event/Program Link? (ie., add'l info, ticket purchase, registration, etc.)* This field is required.

Yes

No

15

Event/Program Link* This field is required.You answered "Yes" to the previous question. Please provide the link below.

16

Event/Program Marketing Materials Upload (ie., flyers, graphics, logos)Please upload copies of any marketing materials (i.e., flyers, graphics, logos, hot cards, etc.) used to publicize the event/program.

Drag and drop files here

Select files to upload

Max. file size: 10.6MB

Please upload any marketing and promotional materials used (ie., flyers, graphics, logos, etc.)

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