Request form for Events, Resources, & Tables

Request form for Events, Resources & Tables
Thank you for reaching out about NAMI Southeast Minnesota's participation in your event! We value your partnership and opportunities to connect with your community.

Please fill out the form below and we will reach out to you shortly.

PLEASE NOTE: We require requests to be submitted at least 15 business days prior to your event. We cannot guarantee acceptance of any requests submitted with less than 15 business days notice.
Name of organization/school *
Address of the organization*

Street Address

Street Address Line 2

CityState

Zip Code
Contact person name *
Email*
example@example.com
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
EmailPhone
Event name*
Event purpose*
Address of Event*

Street Address

Street Address Line 2

CityState

Zip Code
Date of event*

MonthDayYear
Date
Time*

Hour Minutes

AM/PM Option
Who is the primary audience
Est. Attendance*
Are there any specific resources you are looking for?
What will be provided (i.e. table, chairs, tent, electricity, etc...)?
OTHER NEEDS
Any Culturally-Specific Approaches Required?
HONORARIUM
*Honorariums help support and expand NAMI education programs. Donations ensure presenters are well-trained and that educationl programs are available to everyone, regardless of ability to pay. If you are unable to pay the honorarium, please enter "0"and we will work with you to provide the same quality programming at no cost.
$1,000$750$500$250Other
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Request form for Events, Resources & Tables