Careers Event Request Form

Complete the form below to request a UPMC representative for your event.

Please note that UPMC will only consider event requests that are submitted four weeks in advance of the event date.

Contact Information Organization Name:
First Name:
Last Name:
E-mail:
Phone:

Event Information Event Title:
Website: Date:
Start Time:
Event Length: Hours Minutes
:

Event Location

Street Address: Street Address 2: City:
State:
ZIP:

Provide a brief description of the event:

UPMC Attendance Cost:
Participation Requested:
Anticipated Attendance:

Describe the event's target audience:

Include any additional logistical details: