World AIDS Day Events - Submission Form

Please let CATIE know if you are planning a World AIDS Day event by submitting this form.

1. Organization *This question is required.

2. Town/City *This question is required.

3. Province/Territory *This question is required.

4. Event Contact Name

5. Event Contact Email Address

6. Event Contact Phone Number

7. Name of Event *This question is required.

8. Event Location *This question is required.

9. Event Date *This question is required. This question requires a valid date format of MM/DD/YYYY.

calendar

10. Event Start Time *This question is required.

11. Event Finish Time

12. Please include a link to a web page with more information on the event, if available.

13. Please upload a PDF or other file with more information on the event, if available.