Earth911 Pharmaceutical Event Listing Submission Form

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Earth911.com delivers actionable, local information on recycling and product stewardship that empowers consumers to act locally, live responsibly and contribute to sustainability.

To have your event added to the Earth911.com search engine please answer the following questions.

The event will automatically drop from public view after the event is over.

1.

First Name of Event Coordinator/Contact Required Question

Required Question

Last Name of Event Coordinator/Contact Required Question

Required Question

Title of Event or Program

Organization Holding Event Required Question

Required Question

Event/Program Street Address Required Question

Required Question

Apt/Suite/Office or other location clarification

City

Required Question

State

Required Question

Postal Code Required Question

Required Question

Website of Organization

Email Address

Phone Number Required Question

Required Question

Beginning Date of Event Required Question

Required Question

Ending Date of Event (if ongoing, leave blank)

Event Hours Required Question

Required Question

2. Event Description

3. Materials Accepted Required Question

Required Question

	Unwanted Medication
	Medical Sharps Disposal

4. Please select if your event is for drop-off only. Required Question

Required Question

Drop-off only

50%

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