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Information entered into the Center for Black Equity (CBE) database powers our MPV Vaccine locator tool. If your organization provides services and you would like to be included in CBE's searchable database, fill out the form below. Please note that required information is marked with an asterisk (*). The form cannot be processed without all the required information.
Organization Details

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* Address

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* Please provide vaccination requirments 

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* Is this a one-time event or ongoing? 

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* Start Date

Date
Time

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* End Date

Date
Time

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* Hours of Operation

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* Social Media Sites

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* Primary Organization Type

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* Please upload a high res logo

PDF, DOC, DOCX, PNG, JPG, JPEG, GIF file types only.
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