SONJ RV (Mobile Health Vehicle) Request Form
Please submit this form with as much information as possible regarding the event including location, logistics, and points of contact. Thank you.
Name
Department
Please select...
County Coordinator
Development
Development - LETR
Facility/Operations
Finance
Inclusive Education
Program - General
Program - Healthy Athletes
Program - Young Athletes
Regional Director
External Request
Event
Event date
Arrival Time
End Time (Estimate if not exact)
What is the purpose of our presence?
Health Screenings (3 month lead time required)
Branding/Awareness
Information Booth
General Support
Other
Venue Information
County/Counties
Please select...
Atlantic, Cape May, & Cumberland
Bergen
Burlington
Camden, Gloucester, & Salem
Essex
Hudson
Hunterdon & Warren
Mercer
Middlesex & Union
Monmouth & Ocean
Morris & Sussex
Passaic
Somerset
Address
Main Point of Contact (Include email, cell phone, if available)
When does the RV need to be dropped off and picked up?
Who will be driving the RV to and from the venue?
Contact Information