The SheaMoisture Shots At The Shop $1k Grant- Event Form
Fill out the information below.
Name
*
First Name
Last Name
Email
*
example@example.com
Barber Shop/ Hair Salon Name
*
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Training Completion Certificate
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Vaccine Event- Describe the event held (date, time, activities, attendance, etc) *
Vaccine Event Name and Description
*
Did you sign up/ register through SheaMoisture's site?
Yes
No
Event Date (Please enter the date your event took place)
*
-
Month
-
Day
Year
Date
Event Activities
*
Please Select
Vaccine Education Awareness
Vaccine Administration
Both Vaccine Education and Administration
Total Number of People In Attendance
*
Did you work with a pubic health official to coordinate this event?
*
Enter the name or office of the public health official you worked with
How many people got vaccinated at your event?
How did you market or advertise the event?
Vaccine Event Image- Attach images of event flyers, images, videos
*
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Please link any social media posts you have about the event. Paste the links to the social media posts in the box below.
Please allow a few weeks for payment processing. Once the information you uploaded has been verified, we will reach out to you for your payment details. Thank you!
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