Outreach Interest Form Outreach Interest Form Event Information Event Title 10th Annual Arts in the Park Festival2024 Port of Baltimore Open HouseAACPS Celebración del Bienestar HispanoBreast Cancer Awareness Tea Hope and HarmonyCommunity Health & Resource FairFall Community Wellness DayPiney Orchard Elementary Health and Wellness FairPre New Year’s Health & Wellness Resource FairSTEAM night Event Date December 30, 2024December 5, 2024November 13, 2024November 16, 2024October 10, 2024October 12, 2024October 19, 2024October 19, 2024October 5, 2024 Start Time 1:00 PM1:30 PM5:00 PM6:00 PM6:30 PM10:00 AM10:00 AM10:00 AM10:00 AM End Time 1:00 PM1:00 PM2:00 PM3:30 PM3:00 PM4:00 PM7:00 PM8:00 PM8:00 PM Vendor Setup Time 4:30 PM5:30 PM5:30 PM8:30 AM9:00 AM9:00 AM9:30 AM12:30 PM12:00 PM Rain Date Not ApplicableNovember 16, 2024 Venue Address American Legion Post 141Annapolis Middle SchoolBoone Station HallBroadneck High SchoolCox Creek Dredged Material Containment FacilityGeorgetown East Elementary School (Cafetorium)Hammonds Lane TheatrePiney Orchard Elementary SchoolThe Severn Center Venue Address 111 Dogwood Rd.194 Hammonds Lane628 Baltimore Annapolis Blvd1000 Kembo Road1160A Reece Road1265 Green Holly Dr1399 Forest Drive1707 Forest Drive2641 Strawberry Lake Way City AnnapolisAnnapolisAnnapolisAnnapolisBrooklyn ParkCurtis BayOdentonSevernSeverna Park State MarylandMarylandMarylandMarylandMarylandMarylandMarylandMarylandMaryland Zip Code 211132114421146212252122621401214032140321409 Your Information Your Name * Your Name First First Last Last Email Bureau AdministrationBehavioral HealthDPMEnvironmental HealthFamily HealthSchool HealthHERJ - Health Ambassadors Only Program * Administration Programs Attending Central Services Communications Finance HERJ Human resources Information Technology Office of Assessment and Planning Emergency Preparedness Student Volunteer HERJ Health Ambassadors Name of organization: Organizations POC: (Point of Contact) Organizations POC: (Point of Contact) First First Last Last POC Email POC Phone How many team members attending? Behavioral Health Programs Attending Adolescent and Family Services Road to Recovery Clinics Recovery Community Support Services System Planning and Management System Training Education and Prevention Services Disease Prevention and Management Programs Attending Chronic Disease Prevention HIV/STI Prevention and Care Infectious Disease Prevention and Control Immunizations Program Public Health Emerging Pathogens Response Environmental Health Programs Attending Food Protection Services Housing Protection Program Sanitary Engineering Family Health Programs Attending Access to Care Adult Evaluation and Review Services (AERS) Dental Health MA Transportation Maternal and Child Health WIC School Health and Support Programs Attending Audiology Clinical Services Operations Program Representative Name of representative/s: Name of representative/s: First First Last Last Representative/s email address: What materials will you provide? Giveaways Flyers/Brochures Health Screening/Testing Training/Seminar N/A OtherOther Submit