First Name Last Name Organization Name Phone Number Email Address Event Name Event Description/Purpose Estimated Number of Attendees Event Duration Proposed Event Start Date Proposed Event End Date Do you need audio visual services? Yes No Do you require food & beverage service? Yes No Do you require lodging blocks? Yes No Do you require an event website? Yes No Do you require a registration website? Yes No Do you require an abstract submission site? Yes No How did you hear about us? Additional Event Needs (Please check all that apply) Banquet Meal Poster Session Keynote/Plenary Talk Breakout Spaces Wisconsin Union Theater Space Other additional event need (if any): Location Preference Memorial Union Union South Either Union Building Offsite Event Space Other location preference (if any): You must enable JavaScript to submit this form
