Meeting & Group Request Form
Contact Information

* Your Name:
* Company Name:
* Business Phone:
Fax:
Department Name:
Cost Center:
* E-mail:
* Verify E-mail:

Indicate Your Group Needs:
Meeting Space & Sleeping Rooms
Meeting Space Only
Sleeping Rooms Only

Hotel Requirements

* City Hotel Needed:
Specific Area:
Airport.. Downtown ..Other
Indicate Other Location:
Do You Have a Specific Hotel Request:
* Number of Rooms Required Per Night:
Will Attendees be Required to Share Rooms:
Yes
No
Budgeted Room Rate Per Night:
Hotel Check-in Date:
Hotel Check-out Date:

Ground Transportation

* Do You Require Ground Transportation
Yes No

Vehicle Type Required
Shuttle Vans... Bus
From Where to Where?
Airport Transfers...Other
If Other - Explain:

Meeting Space Requirements

Meeting Name:
Desired City for Meeting:
Specific Area:
Airport.. Downtown ..Other
Indicate Other Location:

Anticipated # of Attendees:
Meeting Dates:
Meeting Start Time:
Meeting End Time:

Room Setup:
Classroom
Theater
U-Shape
Other Set-Up
Indicate Other Room Set-Up:

Audio Visual

* Do you require Audio Visual Equipment:
 Yes No

Click All That Apply
LED Projector
Podium
Wireless Internet
Whiteboard & Markers
Screen
Flip Chart & Markers
Microphone & Audio
Other Equipment
Indicate Other Audio Visual Equipment Needed:


Breakout Rooms

* Do you require Breakout Rooms
 Yes No

Breakout Rooms Needed Per Day:
Dates Breakout Rooms Needed:
Seating Per Breakout Room:
Breakout Room Setup:
Classroom
Theater
Boardroom
U-Shape
Other Set-Up
Advise Other Room Set-Up:

Food & Beverage Requirements

* Do you require Food & Beverage:
 Yes No

Check All Appropriate Boxes
Continental Breakfast
Working Lunch
PM Refreshment Break
Full Breakfast
Buffet Lunch
Dinner
Mid-Morning Coffee Break
Sit-Down Lunch
Evening Reception



Let Us Know If This Meeting Has Any Special Requirements: