World Elder Abuse Awareness Day Event Form

Are you holding or co-sponsoring an event or activity in observance of World Elder Abuse Awareness Day this year? If so, we are providing this form for you to share news about your event with the rest of the World! Please take a quick moment to fill out the information below. Your event will be included in the WEAAD Event Map, a state-by-state list of planned events. Thank you for sharing your World Day event, and thank you for taking a stand against elder abuse!

Contact Information: (* = required fields)

* First Name:

MI:

* Last Name:

* Agency/Organization:

* City:

County:

* State:

* Email:

Web site:

Event Details:

* Event title:

* Date & Time (slowly type numbers only; the form will fill in special characters for you):
(format: mm dd yyyy) (format: hh mm)

* Location:

* Type of Event: (select one)

What do you hope to achieve? (check all that apply)

Number of participants you are planning for:

Are you partnering with anyone to host/hold the event? Yes No

* Is this the first time you have organized a World Elder Abuse Awareness Day event? Yes No

Is this the first time your community has observed World Elder Abuse Awareness Day? Yes No

10.

* Description of event (max. 1500 characters):
(do not format the text; use only one space between sentences)

Before Submitting

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