Symposium Meeting & Special Event Request Form

By completing this form your event will automatically be listed in both the printed and online technical program. In early September, you will be contacted by Della Miller to confirm final details, including the exact number of attendee.

 

Contact Information:
Event Name:  
Event Contact:  
E-Mail:  
Phone:   Fax:
   
Event Sponsor(s):  
Event Funding:  

(Please note that all events must be billed back to a specified cost center, i.e, division, committee, outside sponsor, etc.)

 

Type of Event:

 
Session Reception Session/Reception
Committee Meeting Committee Meeting Breakfast Committee Meeting Lunch
Committee Meeting Dinner Committee Meeting Break Other
 

Date:

Start Time:

End Time:

     

Location:

Headquarters Hotel

Convention Center

Other:

Anticipated Attendance:

 

Room Set:
Theatre Classroom U-shape
Conference Table
     (Board Style)		 Reception/Cocktail Rounds (Lunch)
Other

 

Audio Visual

 
Computer Type:    
Flip Chart Number:
Internet Connection Type:    
Handheld Microphone Number:
Type: WiredWireless
Wireless Lapel Microphone Number:
Podium Microphone Number:
Laser Pointer
LCD Package (includes screen)
Overhead Package (includes screen)
Poster Board(s)    Number:
Telephone(s)


 Number:
Type: ConferenceRegular
TV
TV/DVD Player
TV/VCR
Other:

 

Refreshments:

 
None
Breakfast:
Morning Break (coffee, pastries, etc.)
Lunch:
Afternoon Break (sodas, cookies, etc.)
Dinner:
Light Reception (chips, wine/beer, etc.)
Heavy Reception (hot/cold appetizers, beer/wine)
Other:

 

Comments:

 

Questions? Contact:
Della Miller
Events Manager
530-896-0477
della@avs.org