District Announcement and Event Request Form

Use this form to submit a district announcement or event.

District newsletter emails will be scheduled to be sent on Thursdays only.
Please fill out and submit the below form by the Thursday prior to the announcement send date.

If you have any questions please send an email to districts@massdental.org.

Question Title

District Name (Required.)

Question Title

Event Name (Required.)

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Event Date and Time (Required.)

Date

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Event Start Time (Required.)

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Event End Time (Required.)

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CE Credit Info

Number of Credits (if applicable)

Is your district CERP certified?

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Cost

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Registration or Announcement URL

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Add this event to the MDS calendar and district web page

Yes

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Send out an email announcement for this event

Yes

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Requested Send Dates (Required.)

Send first email announcement

Date

Send an email reminder

Date

Question Title

Send draft of Announcement and Reminders to:
*This person will receive a proof of the email by the Tuesday prior to the send date. Please send all changes within 24 hours of receiving the proof.

Name

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Event Location Information

Venue Name

Venue URL

Event Address

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Event Information

Event Overview

Learning Objective 1

Learning Objective 2

Learning Objective 3

Learning Objective 4

Learning Objective 5

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Speaker Information

Speaker

Speaker Bio

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Speaker Photo (optional)

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Additional Information

Question Title

Comments

Question Title

Contact for questions:
If district members have questions about the event, who should they contact?
(Required.)

Name

District Announcement and Event Request Form

Question Title

* District Name (Required.)

Question Title

* Event Name (Required.)

Question Title

* Event Date and Time (Required.)

Question Title

* Event Start Time (Required.)

Question Title

* Event End Time (Required.)

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* CE Credit Info

Question Title

* Cost

Question Title

* Registration or Announcement URL

Question Title

* Add this event to the MDS calendar and district web page

Question Title

* Send out an email announcement for this event

Question Title

* Requested Send Dates (Required.)

Question Title

* Send draft of Announcement and Reminders to:*This person will receive a proof of the email by the Tuesday prior to the send date. Please send all changes within 24 hours of receiving the proof.

Question Title

* Event Location Information

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* Event Information

Question Title

* Speaker Information

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* Speaker Photo (optional)

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* Additional Information

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* Comments

Question Title

* Contact for questions:If district members have questions about the event, who should they contact? (Required.)

District Name (Required.)

Event Name (Required.)

Event Date and Time (Required.)

Event Start Time (Required.)

Event End Time (Required.)

CE Credit Info

Cost

Registration or Announcement URL

Add this event to the MDS calendar and district web page

Send out an email announcement for this event

Requested Send Dates (Required.)

Send draft of Announcement and Reminders to:
*This person will receive a proof of the email by the Tuesday prior to the send date. Please send all changes within 24 hours of receiving the proof.

Event Location Information

Event Information

Speaker Information

Speaker Photo (optional)

Additional Information

Comments

Contact for questions:
If district members have questions about the event, who should they contact?
(Required.)