Special Events Application | Sarah Bush Lincoln

Healthy Communities Special Events Application

Thank you for your request. Our Event Planning Committee will review your request and get back with you. If you have questions, you can reach us at [email protected] .

* indicates a required field.

Your name: *
First & Last

Organization/School/Community Club or Group: *

Phone: *

Email: *

County the event will take place: *

Name of Event: *

Type of event: *
check all that apply

If Other, please explain:

What is the ages of the participants: *
check all that apply

Describe your event and request: *

What is the goal of the activity or event: *

What is the expected number of participants: *

What is the date of the event: *

What is the time of the event: *

What is the expected set-up or tear down time? *

What program or vehicle are you asking to participate: *

SBL Healthy Kids Programming
CORD (Community Online Resource Directory)
SBL Dental Services - Oral Health Education
SBL Healthy Communities Programming / Partnership
The Kickstart Car
The Dental Bus

If you selected Dental Bus, please choose option:

Oral Health Education
Tours
Parades only