GoodWorks Event Request Form
We can't wait to partner with you!
Full Name
First Name
Last Name
Contact Number
Please enter a valid phone number.
Email Address
example@example.com
Name of Organization
Please choose the type of service you're requesting.
Bystander Workshop (Session typically lasts 90 minutes, but it can be shortened to an hour if necessary.)
Pop-up Health Literacy Booth (Flexible duration: Our booth can be set up for up to 6 hours at your event.)
Other
Are you making this request on behalf of a K-12 school or a college/university?
Yes
No
Other
Are you making this request on behalf of a medium-sized or larger nonprofit (e.g., 10+ employees and serving hundreds to thousands of beneficiaries annually)?
Yes
No
Other
Address of Event
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Pick an estimated date & time for your event
Additional Details
Submit
Should be Empty: