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FCRC Community Collaboration Request Form
Use this form to propose a service, program, or event at the Recovery Center.
FCRC Community Collaboration Request Form
lburningha@mainehealth.org
2025-07-29T06:07:40-04:00
Organizer Information
Name of Facilitator / Organization
*
Contact Email
*
Contact Phone
*
Event Details
Title of Event
*
Type of Event
*
Workshop
Tabling
Drop-in Hours
Others (Please Specify)
Other
Purpose / Objectives
*
What are the goals of the event?
Target Audience
*
Specify the intended participants.
Relevance to Community Needs
*
Explain the importance and timeliness of the event.
Logistics
Preferred Date(s) and Time(s):
*
Estimated Duration
*
How long will the event last?
Space Requirements
*
Type of space needed: table, room, outdoor area, etc.
Resources Needed
Materials Required
*
List any materials you will provide and those needed from FCRC.
Budget Estimate
If applicable.
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