Black History Month Event Registration Survey

* Register by February 25, 2025! *

BLACK HISTORY MONTH EVENT 2025

OES ACBHD BHM Event 02.26.2025
______________________________________________________________________
Hosted By:
The Office of Ethnic Services (OES), Health Equity Division (HED)
Alameda County Behavioral Health Department (ACBHD)

Date:
Wednesday, February 26, 2025

Time:
11:00 AM - 4:00 PM

Location:
Redwood Conference Room (1st Floor)
1100 San Leandro Blvd.
San Leandro, CA 94577

Contact:
______________________________________________________________________________


START HERE:

1.Enter your First and Last Name:

(Example: Jane Doe; John Doe)
2.Are you an Alameda County Employee?
3.If so, which Alameda County Agency or Department/Division do you work under?

(Example: Office of The Director, XYZ Health Care)
4.Enter your Title and Organization:

(Example: Director of Operations XYZ Health Care)
5.Enter Your Phone Number:

(Example: (510) 555-5555)
6.Enter your Email Address:

(Example: Name@Domain.com)
7.Will you be needing accommodations for special needs? If so, please describe below.

(Example: Wheelchair Assistance; Vision Assistance; Auditory Assistance etc.)
8.How did you hear about this event?