A World Free of MS

The Greater Delaware Valley Chapter welcomes listings of educational programs and events sponsored by groups in our community. This may include (but is not limited to) health fairs, workshops, teleconferences or self-help group meetings on topics of interest to people living with MS, family members and caregivers.

To add your program to our chapter calendar, submit the form below. Contact Mollie Burns with questions at 215-271-1500 or mollie.burns@nmss.org. If you are a pharmaceutical company representive, please contact Mollie directly (215-271-1500 or mollie.burns@nmss.org).

Please note: All requests will be reviewed by National MS Society staff prior to being posted. We reserve the right to refuse programs that appear to be inconsistent with the Society’s mission. Agreeing to list your program on our calendar is not an endorsement or recommendation of the specific products or services your group provides.

1.

Please enter your contact information:


*	Title:
*	First Name: Required
	Middle Name:
*	Last Name: Required
	Suffix:
	Professional Suffix:
*	Email: Required
*	Street 1: Required
	Street 2:
*	City: Required
*	State/Province Required
*	ZIP / Postal Code: Required
	Country:
*	Phone Number: Required
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*2.

Question - Required - Company/organization:

*3.

Question - Required - Event name:

*4.

Question - Required - Date of event:

Month

Day

Year

*5.

Question - Required - Event start and end times:

6.

Question - Not Required - Additional dates/times of event:

*7.

Question - Required - Event location: (include the full address)

*8.

Question - Required - Registration phone number:

9.

Question - Not Required - Additional registration information:

(Maximum response 255 chars, approx. 5 rows of text)

10.

Question - Not Required - Web site for event (or company Web site):

*11.

Question - Required - Please include a description of your event:

*12.

Question - Required - I would like a representative from the National MS Society to attend and/or exhibit at my event. (If you select yes, a representative will contact you to discuss further.)

13.

Question - Not Required - If you have already spoken to a staff member about this event, please tell us who you spoke with:

(Maximum response 255 chars, approx. 5 rows of text)

14.

Question - Not Required - Would you like collateral materials (brochures, flyers, etc.) to distribute at your program?

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