ArizOTA Marketing & SIS Event Request Form

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Title of the marketing request or event* This field is required.(e.g. March pediatric SIS meeting, 2/23/2021 CMS news, 2021 Fall Conference call for papers, etc.)
2
Event Date* This field is required.Write N/A if needed.
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Event Time (start-end)* This field is required.Write N/A if needed.
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Have you verified that your suggested date listed above does not conflict with other events on the shared calendar?* This field is required.Please add your event to the calendar if you are able to do so.
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When does this marketing request need to be completed?* This field is required.If you have more than 1 deadline, please describe your expectations clearly. SIS events are typically marketed 1-2 weeks in advance of event date, depending on that month's number of requests. MARKETING REQUESTS NEED TO BE SUBMITTED AT LEAST TWO WEEKS IN ADVANCE OF THE REQUESTED MARKETING DATE. Requests submitted within the two-week window will be processed as soon as possible within the capabilities of the ArizOTA Marketing Team.
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Is a registration form needed for this event?* This field is required.If yes, the event registration will be created via Jotform.
YESNO
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Is this a CEU(s) event?* This field is required.
YESNO
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Speaker's Name
First Name
Last Name
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Speaker's CredentialsHow does the Speaker want their credentials printed after their name on event materials?
10
Speaker Phone Number
Area Code
Phone Number
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Speaker Email
example@example.com
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Additional Speakers' Names with credentials AND Email Addresses
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Which ArizOTA Special Interest Section/Committee/Partnership is this for?
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How many CEU(s) will be offered?* This field is required.
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Please list at least two learning objectives for your meeting/event.* This field is required.
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Brief description of the presentation (100 words or less)
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Biography of each speaker (25 words or less- for marketing and introduction)
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Do you need a Zoom link generated for your event?* This field is required.
YESNO
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Moderator Name* This field is required.This is the person who is responsible for overseeing the event the day of (e.g. could be the Speaker, Committee/SIS rep).
First Name
Last Name
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Moderator Email* This field is required.The Moderator will receive instructions for hosting the meeting at least three days in advance.
example@example.com
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With which audiences would you like your news/event shared? Check any/all that apply.* This field is required.
All licensed OT practitioners in AZ
ArizOTA members (practitioners and students)
OT/OTA programs (Please only check this for news or events directly and significantly pertaining to students)
ArizOTA practitioner members ONLY
ArizOTA student members ONLY
Other
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Please provide all relevant details you would like shared with your selected audiences. * This field is required.Include date, time, cost, sign-up link, etc.
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Please upload any pertinent files for your marketing request.Images, flyers, documents, etc.
Drag and drop files here
Select files to upload
Max. file size: 10.6MB
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Through which channels would you like your news/event shared? Select all that apply.* This field is required.
Website
Email
Social Media
Leave to the discretion of ArizOTA Marketing & PR Committee
Other
25
Please share anything else you feel is important!
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Contact Name* This field is required.Who should we contact with questions?
First Name
Last Name
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Contact Email Address* This field is required.
example@example.com
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Contact Phone* This field is required.In case we have an urgent question
Area Code
Phone Number
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