EmailMe Form - AFLV Central | Special Event Space Request Form

Name *

First Last

Email: *

Cell Phone *

### - ### - ####

I'm a/an: *

Institution/Organization *

Event Title *

Please provide a brief description of the event. *

Would you like this event published in the program book? *

Yes

No

Preferred start date & time *

MM / DD / YYYY HH : MM AM/PM

Preferred end date & time *

MM / DD / YYYY HH : MM AM/PM

Alternative start date & time *

MM / DD / YYYY HH : MM AM/PM

Alternative end date & time *

MM / DD / YYYY HH : MM AM/PM

Expected number of attendees? *

Preferred Room Set: *

Do you need to be put in contact with the hotel for food & beverage needs? *

Yes

No

Audio/Visual Request: *

If your audio/visual request exceeds what AFLV has available we will get you in contact with our A/V company to order directly through them. Additional charges may apply.

Are there any other requirements needed for the event or additional notes you would like to share?

Event Space Agreement

By submitting this event space request form you acknowledge and agree to the following:

All boxes must be checked in order for your
submission to be complete. *

I understand that I will be invoiced $100 per hour rental fee for this event and I agree to pay that invoice with 30 days of receipt. This does not include additional audio/visual charges, as requested.

I understand that I may not make changes to my event request after Monday, December 3, 2018.