Virginia Lantern Message Request Form

Virginia Lantern Message Blast Request Form

Early Impact Virginia has partnered with Lantern to send targeted text messages about free and low-cost local events and resources to expectant parents and families with young children across Virginia. Use this form to request that your event or resource be shared with families in your community.
All requests must be made at least one week in advance of when you'd like the message to be sent out.
Your Name

First NameLast Name
Organization/Employer
Email Address
example@example.com
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Event Name or Resource Topic
For internal EIV use only
Event Date (if applicable)

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Event Time (if applicable)
Target Audience
Who is this event designed for? Is this for prenatal clients only? Families with children any age? A resources for a target age group?
Localities
Please list all the localities (cities and counties) that you would like this message to be sent to.
Link to Event Information, Details, or Resource
Event cost:

Other
Draft Message for Text Blast (max 140 characters)
Preferred date of message blast

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Further details or information you'd like to share:
Should be Empty:

Virginia Lantern Message Blast Request Form