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Health Fair & Speaker Requests

   

Interested in Having the American Diabetes Association at Your Upcoming Event?

The American Diabetes Association Jacksonville Office is happy to work with local organizations to host health fairs and send representatives to speak about diabetes.

Please fill out the form below. We look forward to hearing from you!

 

Request for Health Fair

Contact Name:
Telephone:
Email:
Organization:
Organization Address:
City:
State:
Zip Code:
Audience Information  
Anticipated Event Size (Approximate number of Participants):
Event Age Range:
Language(s) Spoken by Audience:
Please specify if you need basic diabetes information or more specific target audience:
Location Information  
Date of Event:
Start/End Times of Meeting or Fair:
Event Address (If different than Organization):
City:
State:
Zip Code:
Speaker Requests Only:  
Start/End Times for Speaker Presentations:
Presentation Topic:
Is this workshop open to the public?:
     

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American Diabetes Association • 1701 North Beauregard Street • Alexandria, VA 22311 • 1-800-DIABETES (800-342-2383)

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