Note: Press coverage opportunities are only available for oral health care educational events connected to your practice or the District and/or oral health and non-oral health related community service activities involving the District.

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* 1. Event Contact Information:
Who should we contact with any questions about this request?

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* 2. District Name

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* 3. Event Name

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* 4. Event Date and Time

Date

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* 5. Event Start Time

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* 6. Event End Time

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* 7. Event Location Information

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* 8. Event Information

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* 9. Publications to Send Release (up to five)

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* 10. Photo (if applicable)

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

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* 11. Photo Caption (identify location and full names of those photographed)

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* 12. Upcoming Events

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* 13. Additional Comments

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