Hygiene Kit Assembly Event Inquiry

Hygiene Kit Assembly Event Inquiry

Thank you for your interest in building hygiene Kits
Employee
Employee Name

First NameLast Name
Type of Event
Type of Event 2
Event Type ID
Are you interested in sponsoring a Hygiene Kit Build?
Organization/Group Name
Contact Name

First NameLast Name
Contact Email
example@example.com
Contact Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Has your organization/group built kits with HHI before?
Organization Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Which of the following best describes your group?
Do you know where the event will be held?
Is it the same as your organization address?
Where are you planning on having the event? (Location, City, State)
Event Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
How many participants ages 18+ are you expecting?
How many participants ages 10-17 are you expecting? (Unfortunately we are unable to accommodate participants under 10)
Please choose 2 dates that would work for your event (these are tentative until confirmation from Heart to Heart International). Currently we are only accommodating requests Tuesday-Thursday. Each session is 90 minutes. We will need a minimum of 3 weeks to plan your event.
Please choose 2 dates that would work for your event (these are tenative until confirmation from Heart to Heart International.) If you do not know the exact date, please enter a tenative date around when you are thinking.
1st Date choice

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
1st Time of day
1st Date Option

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
1st Option Time of day
2nd Date Choice

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
2nd Time of day
2nd Date Option

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
2nd Option Time of Day
Confirmed Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Hour MinutesAM/PM Option
1st Date Actual

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
2nd Date Actual

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
1st Time of day actual
2nd Time of day actual
Additional Comments
Should be Empty: