District Announcement and Event Request Form

Use this form to submit a district announcement or event.

District newsletter emails will be scheduled to be sent on Thursdays only.
Please fill out and submit the below form by the Thursday prior to the announcement send date.

If you have any questions please send an email to districts@massdental.org.

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* District Name

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* Event Name

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* Event Date and Time

Date

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* Event Start Time

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* Event End Time

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* CE Credit Info

Number of Credits (if applicable)

Is your district CERP certified?

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* Cost

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* Registration or Announcement URL

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* Add this event to the MDS calendar and district web page

Yes

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* Send out an email announcement for this event

Yes

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* Requested Send Dates

Send first email announcement

Date

Send an email reminder

Date

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* Send draft of Announcement and Reminders to:
*This person will receive a proof of the email by the Tuesday prior to the send date. Please send all changes within 24 hours of receiving the proof.

Name

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* Event Location Information

Venue Name

Venue URL

Event Address

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* Event Information

Event Overview

Learning Objective 1

Learning Objective 2

Learning Objective 3

Learning Objective 4

Learning Objective 5

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* Speaker Information

Speaker

Speaker Bio

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* Speaker Photo (optional)

Please upload a speaker photo here

PDF, DOC, DOCX, PNG, JPG, JPEG, GIF file types only.

Choose File

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* Additional Information

Please upload any additional event information files

PDF, DOC, DOCX, PNG, JPG, JPEG, GIF file types only.

Choose File

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* Comments

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* Contact for questions:
If district members have questions about the event, who should they contact?

Name

District Announcement and Event Request Form

Question Title

* District Name

Question Title

* Event Name

Question Title

* Event Date and Time

Question Title

* Event Start Time

Question Title

* Event End Time

Question Title

* CE Credit Info

Question Title

* Cost

Question Title

* Registration or Announcement URL

Question Title

* Add this event to the MDS calendar and district web page

Question Title

* Send out an email announcement for this event

Question Title

* Requested Send Dates

Question Title

* Send draft of Announcement and Reminders to:*This person will receive a proof of the email by the Tuesday prior to the send date. Please send all changes within 24 hours of receiving the proof.

Question Title

* Event Location Information

Question Title

* Event Information

Question Title

* Speaker Information

Question Title

* Speaker Photo (optional)

Question Title

* Additional Information

Question Title

* Comments

Question Title

* Contact for questions:If district members have questions about the event, who should they contact?

* Send draft of Announcement and Reminders to:
*This person will receive a proof of the email by the Tuesday prior to the send date. Please send all changes within 24 hours of receiving the proof.

* Contact for questions:
If district members have questions about the event, who should they contact?