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Shave or Dye

Man Alive! project launch video

Request for ManAlive male health initiative

Organisation name: *

Contact Person: *

Address:

Email:

Telephone number:

Type of event: *

(e.g. health fair, presentation)

What input do you require from ManAlive? *

(e.g. information stand, presentation, health checks)

Please describe your target group: *

We have several programmes running that we’d be happy to discuss.

Venue for event:

Venue Address:

Proposed date/s of event:

(if possible please provide a few alternative dates)

Proposed time of event:

How long it is expected to last?

How many attendees do you expect?

Copyright 2011

ManAlive! Programme
40- 44 Eglantine Avenue, Belfast BT9 6DX, Northern Ireland
T: + 44 (0) 28 9066 3281 l F: + 44 (0) 28 9066 8715

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