Event Host Information

Name of Event Hosting Organization  
Address of Event Hosting Organization
Phone Number   Fax Number
Email Address   

Primary Contact Information

Primary Event Contact Name
Primary Event Contact Title
Primary Phone Number   Primary Cell Phone Number
Primary Event Email Address 

Secondary Contact Information

Secondary Event Contact Name
Secondary Event Contact Title
Secondary Phone Number   Secondary Cell Phone Number
Secondary Event Email Address 

Event overview section

Please provide an overview of the Event you would like our help with in the box provided below
Does your organization have a website?   
If so what is the URL?  
Do you plan to put anything on your website to promote this event.  
Are there other sites that have relevant information about your event?  
If so, please list the URL's below:  

Other 1
Other 2  
Other 3  
Other 4  
Other 5  
Does the Presenter/Featured speaker have a website?  
If so, please give the URL  
Is this a recurring event?  
What are the date of the event? Beginning Date:      Ending Date    
What is the maximum number of people you can accomodate?  
Will there be a registration or admission charge?  
If so, how much?