MEC Information Packet

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INFORMATION PACKET

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Contact Information
*First Name:
*Last Name:
*Company/Organization:
*Address 1:
Address 2:
*City:
*State:
*Country:
*Postal Code:
*Daytime Phone Number: xxx-xxx-xxxx
*Fax: xxx-xxx-xxxx
*Email:
General Comments / Specific Inquiries

Event Information
*Event Name:
*Type of Event
If Other:
*Arrival Date: (mm/dd/yyyy)
*Departure Date: (mm/dd/yyyy)
*Dates Flexible?	Yes No
Alternate Dates:
Arrival Date: (mm/dd/yyyy)
Departure Date: (mm/dd/yyyy)
Event Summary:

Estimated Budget for your meeting/program:	$

Meeting Space
Date(mm/dd/yyyy)	Start Time	End Time	# Attendees	Preferred Room Setup

Audio/Visual Needs
High Speed Internet	Conference Phone	Screen
Data Projector	Computer/Laptop	Dial Up Internet
Television	Overhead Projector	VCR
Flip Chart	White Board	Video Conferencing
Document Camera	Microphone	Podium

Catering Needs
Breakfast	Morning Break
Lunch	Afternoon Break
Dinner	Reception/Cocktail

Additional Information
How did you hear about The Management Education Center?
I am an alum	Referred by an alumni
Attended an event here	Referred by business associate
Web Site	Publication
Tradeshow	Other
If other, please explain how you heard of us; if referred by someone, please provide us with their name and affiliation:

Additional Comments: