Providing education and compassionate support to empower our community

 

Special Event Table Request Form

Name:

Title:

Phone:   E-mail:

Address:

Event Date/Time:

Setup Time:

Event Description:

Event Location:

Are there any specific materials you would like us to bring?:

 

If you have any questions regarding any of our programs please contact our Education Coordinator.

Crime Victims Assistance Center, Inc

723-3200

722-4256