Select Date:
Month
January
February
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April
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October
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December
day
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Year
2003
2004
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Event Title:
Presenter Contact:
Name
Phone Number
Email
Additional Presenters:
(please list the names of any additional presenters and include
what they will be doing at the presentation)
Type of Event:
(i.e. lecture, theatrical performance, concert, seminar, dance
recital, film)
Attendance #
(approximate number of the minimum attendees expected to hold
this event through the maximum number of attendees)
Primary Audience:
(i.e. community, students, faculty, staff, children, religious
organizations, businesses, government, etc.)
Secondary Audience:
(i.e. community, students, faculty, staff, children, religious
organizations, businesses, government, etc.)
Event Time Line
Pre-Event Set Up
(time you need to get in the door to start your set up)
Pre-Reception Start
(time you expect people to start taking part in a pre-event reception)
Pre-Reception End
(time your pre-event reception is over)
Doors Open
(time you would like people to be able to get in the building)
House Open
(time you would like to people to be able to get into the seating
area)
Event Start
(time your event begins)
Break
(time you expect to take an break)
Event Resumes
(time you expect to resume after break)
Event Ends
(time your event ends)
Q&A
(duration of a question and answer period following your event)
Post Reception Start
(time you expect people to start taking part in a post event reception)
Post-Reception End
(time your post event reception is over)
Post Event Strike
(time you will begin clean up and removal of your supplies, equipment
etc.)
Physical Plant Needs
Number
pre-show
Tables
Chairs
Podiums
Easels/Flip Charts
Flags/Banners
Exterior Directional Signs
Decorative Plants
Tents
Other
post show
(ie cleaning, table removal)
Room set-up
(describe how you would like the room set-up)
Media Setup
Number
Projectors
Laptop Computers
Screens
Microphones (lapel, hand-held, etc)
TVs
Speakers
Video Cameras
Electrical Requirments
Other
Copying
Will you need material copied?
Yes
No
Material presentation
(describe how you would like the materials to be collated, i.e.
stapled, in folders, in binders, etc.)
Will evaluations be needed/Given?
Yes
No
Catering
* Catering will increase participants
fee for the event.
Catered event?
Yes
No
(describe what kind of food you would like at the event and
when)