Contact Information
Name
Email
Phone

Meeting Information
Name of Meeting
Date of Meeting
(Form: mm/dd/yyyy)

Display schedule for that day
Start Time
Stop Time
Preferred Room
Number of Attendees
(estimate if necessary)
Seating Requirements
Refreshments
(optional)

(eg: Water, Coffee, Tea, Juice, Soda)
Food
(optional)

(eg: Donuts, Muffins, Cookies)
Intent to apply for SCECHs (45 day lead time required)
Special Billing Information/Room Requirements