Minority and Multicultural Health Calendar Item Submission Form

Thank you for submitting your event to be considered for inclusion in the Minority and Multicultural Health Calendar. Please use this form to highlight health and wellness events, notices and activities that are of special interest to American Indians and Populations of Color. The Office of Minority and Multicultural Health (OMMH) reserves the right to edit event submissions. For more information about the calendar, please contact ommh@state.mn.us.

Event name *
Date *
Time *
Event location *
Address
City
State
Zip code
Event Audience
Cost or fee
(if applicable)
Registration deadline
(if applicable)
Event description *
Where can our readers get more information?
Contact information will be displayed.
Contact name*
Phone*
(xxx-xxx-xxxx)
Fax
(xxx-xxx-xxxx)
Email address *
Web site
Contact and submitter info is same
Submitter's contact information
Your name*
Email address*
Passphrase
To prevent abuse of this form, please type the following letters/numbers ZAPRT into the field below. Thank you.

required

 

 

Last Modified: 12-Apr-2011 08:41:37 am