Program/Event Request Form

Submitted by admin on Tue, 03/15/2011 - 04:19

This form must be completed and submitted at least 2 weeks prior to requested/planned event time

Name: *

Email Address: *

Phone Number: *

Name of the Program:

Description of the Program:

Provide a brief description of program: Include Topic, Information on Speakers, format etc.

Preferred Date:

Alternate Date:

Start Time:

End Time:

Expected Attendance:

Type of the Program/Event:

Sponsoring Organization if any:

Tables:

How Many:

Chairs:

How Many:

Podium/Stage:

Location:

Select if there is any specific preference for location of the program.

AV Media:

Specify if there are any Audio Video needs Like, Camera, Projector , Laptop etc.

Comment on Flyers, Communication Needs: