Event Registration Form

All selections in BOLD are required.

Event Information:

Main Contact

Email

Name of Event

Primary Department/Center/Program:

Select your Department/Center/Program

Date and Time

Date

Start Time

End Time

Location

Other

Facilities & A/V Requests

If you would like us to make logistical arrangements for you, please list items and quantities needed from facilities and A/V: tables, chairs, garbage cans, PA system, projector, van, etc.

Description of Event:

This will be used for calendar entries and web publicity. 100-300 words preferred. Include the sponsors at the end of the message.

Publicity Plan:

How will the event be publicized?

Budget Estimate:

What do you plan on buying?

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