Add Your NLAAD 2019 Event

Event Registration

Welcome to our 17th Annual National Latino AIDS Awareness Day Campaign.

Please provide us with the information of your event and if you need support with HIV rapid test, also fill the request form at the bottom of this page.

Question Title

* Event Title:

Question Title

* Host organizations(s) [please list any partners you might be collaborating with, including your organization]:

Question Title

* Event Description (English):

Question Title

* Event description (Spanish):

Question Title

* Event Date/Time

Start

Date

Time

AM/PM

Finish

Date

Time

AM/PM

Question Title

* Contact Person

Name *

Title *

Organization *

Address

City/Town *

State/Province *

ZIP/Postal Code *

Email Address *

Phone Number *

Question Title

* Event Location

Location where the event will happen *

Address *

Address 2

City/Town *

State/Province *

ZIP/Postal Code *

Question Title

* If you have a poster or flyer please share it with us

JPEG, JPG, PNG file types only.

Choose File

Question Title

* Will there be HIV testing at the event?
If yes, and you need testing kits, please fill the "HIV tests Request Form" on our website))

Yes

IF YOU NEED HIV TESTING KITS PLEASE FILL THE FOLLOWING "REQUEST FORM"

This year for NLAAD 2019, we have secured donations of testing kits from :
- ORASURE (Oraquick ADVANCE HIV 1-2 Rapid Antibody Test)
- BioLytical (INSTI HIV-1/HIV-2 Rapid Antibody Test)
Unfortunately Abbott Laboratories is experiencing a supply constrain that is preventing from supporting us with Alere Determine HIV test kits this year.
Once you request your tests, we will process it with the respective Laboratory, and they will send them directly to the person and address listed as the Contact in the beginning of this form.
PLEASE NOTE THERE ARE A LIMITED NUMBER OF FREE TESTING KITS AVAILABLE FOR DISTRIBUTION. WE ASK THAT YOU HONESTLY REQUEST TESTING KITS IF YOU NEED THEM TO BE USED DURING YOUR NLAAD EVENT, SO THAT AS MANY PARTNERS CAN BENEFIT FROM HAVING TESTING KITS AVAILABLE.
COMPLETING THE REQUEST DOES NOT GUARANTEE YOU WILL RECEIVE TESTING KITS.
ALSO, WE WILL ASK FOR A REPORT AT THE END OF THE EVENT WITH INFORMATION OF NUMBER OF TESTS PERFORMED AND RESULTS (NUMBER OF POSITIVE RESULTS, IF ANY)

The following are the possible options (Please read well before choosing).
1) Oraquick ADVANCE HIV 1-2 Rapid Antibody Test - 25 HIV tests (1 package of 25 tests per event) - FREE - only 27 packages available
2) INSTI HIV-1/HIV-2 Rapid Antibody Test - 50 HIV tests (1 package of 50 tests per event, 25 are free and 25 would require payment for your organization) ($274.75)
You will be invoiced directly by Biolytical.

Question Title

* What type of test would you require?

Oraquick ADVANCE HIV 1-2 Rapid Antibody test (1 kit of 25 tests) (Free)

INSTI HIV-1/HIV-2 Rapid Antibody Test (1 kit of 50 tests - you pay for 25 of them) ($274.75)

NONE - I DON'T NEED ANY TEST - NOT APPLICABLE

Question Title

* Event Title:

Question Title

* Host organizations(s) [please list any partners you might be collaborating with, including your organization]:

Question Title

* Event Description (English):

Question Title

* Event description (Spanish):

Question Title

* Event Date/Time

Question Title

* Contact Person

Question Title

* Event Location

Question Title

* If you have a poster or flyer please share it with us

Question Title

* Will there be HIV testing at the event? If yes, and you need testing kits, please fill the "HIV tests Request Form" on our website))

Question Title

* What type of test would you require?

* Will there be HIV testing at the event?
If yes, and you need testing kits, please fill the "HIV tests Request Form" on our website))