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Brain Awareness Event Request

Requested Event Date(s)
*Indicates a required field.
  1. (mm/dd/yyyy)
  2. (mm/dd/yyyy)
  3. (mm/dd/yyyy)
School/Community Organization Information
  1. (e.g. xxx-xxx-xxxx)
Brain Outreach Event Details
  1. Is a team of volunteers requested, or 1-2 instructors?
  2. Preferred Time of Day
  3. Number of Hours for Program
  4. Are media personnel welcome?
    (e.g., reporters from local newspapers and/or newstations)
  5. May a Brain Awareness photographer take photos at the program?
  6. Have Brain Awareness volunteers visited your school/community organization before?

Questions? Contact BAW organizers  at neurobaw@gmail.com or call at 801-585-0343

Last Updated: 1/24/17