Community Request Form

Indicates required field

To request NHMLA’s participation at your community event, please complete the form below. You will receive an email response within 4-6 weeks informing you of the status of your request.

Contact Information

First Name

Last Name

Title

Phone

Event Information

Event Name:

Name of hosting organization:

Event street address:

Event City:

Event Zipcode:

Event Date

Event Description:

Event Website

Event Start Time

Event End Time

Museum participation time (what length of time are you requesting the Museums participation?):

Who will the event serve?

What is the expected attendance?

Are there any confirmed exhibitors? If so, please list:

How would you like the Museum to participate?

Information Materials Only

Table/booth with people

Presentation/program

Mobile Museum (limited availability)

Other…

Parking location (Mobile Museum requests only):

The Mobile Museum trailer requires a level parking space that is 65ft x 20ft in width, with a 14ft vertical clearance. Describe the intended parking location for the trailer. Please note that the Mobile Museum has limited availability and a site check will be conducted in order to confirm the parking location is accessible for the Mobile Museum.

Existing relationship with the museum? If so, please explain:

Community Request Form

Contact Information

Event Information

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