South Carolina Emergency Contraception Event Notification Form
Name of Organization *
Exact location of event
Date of event
Who is invited?
Who should people contact with questions (e-mail or phone number)?
Provide a three- to five-sentence description of the event.
Resources and Materials needed: (List the amount to all that apply):
(See a list of materials we offer)
Informational brochures for young women and men
Informational brochures for health care providers
Other (please specify):
be involved in the planning and execution of the event?
(Please include information on organizations,
What is the goal
of the event? What do you hope to accomplish by doing
willing to speak with the media about this event? If yes, please provide the specific date(s), time(s), and place(s) when you would want media coverage?
How will you
know you have been successful? (What measure of
victory will you use? For example, you might aim at a
specific number of petition signatures or letters
written or a number of participants, media coverage,
policy change, and/or the establishment of local