First Name:
Last Name:
Title:
Association:
Address:
City:
Zip Code:
Phone:
Fax:
Email Address:
Name of Event:
Event Location Name:
Type of Event:
Brief Description of Event:
Date of Event:
Event Start Time:
Event End Time:
Time Officer's Remarks Begin:
Type of Remarks:
Type of Audience:
Name of Officer Requested:
Audience Size:
Additional Comments:
EVENT INFORMATION FORM
Use this form to Request the Attendance of a C.A.R. Officer at an Event
Required fields are in red
Event Location Address:
Event Location City:
Zip Code:
Region:
Required format for phone and fax: 000-000-0000
Required format for dates: mm/dd/yy
Will the Officer need to Arrive the Night Before?
First Choice for Date of Event
Second Choice for Date of Event
Third Choice for Date of Event
If the Officer needs to arrive the night before, will you Arrange Hotel Accommodations?
Will you Arrange Airport Pickup for the Officer?
For additional information, please contact Mary Martinez at 213-739-8397.
Is this event being sponsored by any Vendors, or by other companies or individuals?
If this event is being sponsored, please list Sponsor(s) names here:
Regional Visit
Local Association Visit
Local Board of Directors
Installation Ceremony
Leadership Conference
Other
Yes
No
Keynote Address
Moderator
Speaker Introduction
Administer Oath/Award Presentation
Moderator
Town Hall Discussion
Other
C.A.R. Directors
General Membership
Local Association Leadership
Public
Less than 25
25-50
51-100
101-200
More than 200
Yes
No
Yes
No
Yes
No