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Habitat on Wheels Event Attendance Request Form
Thank you for considering our Mobile Unit to attend your event. To help us better understand your event and if it is applicable to the Habitat on Wheels mission, please fill out the following form.
* Indicates required question
Email
*
Record my email address with my response
Requesting Organization's Information
Name of Requesting Organization
*
Your answer
Contact Person's Name
*
Your answer
Email Address
*
Your answer
Phone Number
*
Your answer
Requesting Organization's Website
Your answer
Event Details
Event Name
*
Your answer
Event Date(s)
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MM
/
DD
/
YYYY
Event Time (start and end)
*
Your answer
Event Location
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Your answer
Expected Number of Attendees
*
Your answer
Brief Description of Event
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Your answer
Does your event fall into a community most impacted by urban heat (purple and red areas on map)?
Interactive Map
*
Your answer
Participation Details
Type of participation requested (please check all that apply)
*
Free Native Plants
Habitat at Home Outreach Materials
General Tucson Audubon Outreach Materials
Kid's Activities
Lucy's Warbler nestbox building
Native Bee nesting block building
Other:
Required
What is the event's target audience?
*
Your answer
Logistical Information
Is there enough space to accommodate a 20' x 7' cargo trailer and truck?
*
Yes
No
Additional Information
Why do you believe that the Habitat on Wheels Mobile Unit would be a good fit for your event?
*
Your answer
The Habitat on Wheels' free program is supported by donations, prioritizing resources to underserved areas of our comunity. If you would like a free plant give away to be a part of your event, do you have the resources to cover the cost of plants?
Yes
No
Other:
Any additional comments or information
Your answer
Send me a copy of my responses.
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