National African American Hepatitis C Action Day 2016

Thank You

We appreciate your interest in National African American Hepatitis C Action Day 2016 and welcome you as a partner. If you have any questions, e-mail info@nblca.org.

Question Title

* 1. Our organization participated in National African American Hepatitis C Action Day 2015 (NAAHCAD). Please use the organizational information provided last year.

Yes, our organization will participate in NAAHCAD 2016.

Question Title

* 2. Did you participate in NAAHCAD 2015

Yes

Question Title

* 3. Did you participate in NAAHCAD 2014

Yes

Question Title

* 4. Did you participate in NAAHCAD 2013

Yes

Question Title

* 5. Organization Name

Question Title

* 6. Organization Information

Contact Name: *

City/Town: *

State: *

ZIP: *

Country:

Email Address: *

Phone Number: *

Question Title

* 7. Please tell us about your 2016 NAAHCAD event(s). (Check all that apply.)

Outreach & Testing - Testing and linkage to care

HCV Health Literacy - Workshop to educate the community

Social Marketing Campaign - Facebook, Twitter, Instagram, other

Town Hall/Policy Intervention - Target policy-makers and legislators

Other (please specify)

Question Title

* 8. Do you need capacity building assistance?

Yes

Question Title

* 9. T-shirt size (Total Qty 2)

	Qty
Medium	Medium Qty menu
Large	Large Qty menu
X-Large	X-Large Qty menu
2X-Large	2X-Large Qty menu

Question Title

* 10. Please provide details about your event.

We will be in contact soon, in the meantime, If you have any questions, please e-mail Melissa Baker at info@nblca.org. We look forward to working with you.

The National Black Leadership Commission on AIDS, Inc., (NBLCA) is a 501c3, not for profit organization with a mission to educate, mobilize, and empower Black leaders to meet the challenge of fighting HIV/AIDS and other health disparities in their local communities. Founded in 1987, and headquartered in New York City, NBLCA is the largest nonprofit organization of its kind in the United States.