Event Request - AutoVitals

Point of Contact

Point of Contact Name*

First Last

POC Email

POC Phone*

Name Of Person Requesting Event*

First Last

Email Of Person Requesting Event

Event Name*

Event Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Event is best described as*

Upload any event materials you have received

Date of Event*

Website For Event*

Google Doc for Event

Time For Set up*

: HH

MM

Time For TradeShow

: HH

MM

Do we have the opportunity for a breakout session?*

Time For Break Out

: HH

MM

Afiliations*

Other (list)

Cost of Event (if Known)

Number of Attendees*

Lead Generation Goal?*

Attendees Are...*

If other Specify

Tell us Why we Should attend this Event*

How Many AV team members needed to Attend?*

What Assets Do you need*

How many of the above assets do you need?*

Sponsorship*

Are There door prizes or raffle prizes for this event we need to provide? please list