Please fill out as much information as possible. This form is an information request only. It is not a binding document until a contract is prepared and signed by both parties. If you prefer to contact us directly, feel free to contact us at Conference.Program@cwu.edu, (509) 963-1141, or toll free at (800) 752-4379.

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Organization Information

Organization Name: *

Street Address: *

City: *

State: *

Zip Code: *

Phone: *

Fax:

Email: *

Name of Contact Person: *

Organization Website Address:

Event Details

Name of Proposed Event:

Event Description:

Start Date:

Month MonthJanFebMarAprMayJunJulAugSepOctNovDec

Day Day12345678910111213141516171819202122232425262728293031

Year Year20002001200220032004200520062007200820092010201120122013201420152016201720182019202020212022202320242025202620272028

End Date:

Month MonthJanFebMarAprMayJunJulAugSepOctNovDec

Day Day12345678910111213141516171819202122232425262728293031

Year Year20002001200220032004200520062007200820092010201120122013201420152016201720182019202020212022202320242025202620272028

Group Type:

Adult

Youth

Non-Profit

State/Federal Agency

Private

Estimated Number of Participants:

Types of Facilities (check all that apply):

Small (0-35)

Medium (35-75)

Large (75-200)

Banquet

Auditorium (300-750)

Theater (300)

Ballroom (1000)

Other (fields, gym, pool, etc.)

How many specifically?

Housing/Dining

Estimated Number Staying on Campus:

Estimated Check-In Date:

Month MonthJanFebMarAprMayJunJulAugSepOctNovDec

Day Day12345678910111213141516171819202122232425262728293031

Year Year20002001200220032004200520062007200820092010201120122013201420152016201720182019202020212022202320242025202620272028

Estimated Check-Out Date:

Month MonthJanFebMarAprMayJunJulAugSepOctNovDec

Day Day12345678910111213141516171819202122232425262728293031

Year Year20002001200220032004200520062007200820092010201120122013201420152016201720182019202020212022202320242025202620272028

Estimated Number of Meals:

Date of First Meal:

Month MonthJanFebMarAprMayJunJulAugSepOctNovDec

Day Day12345678910111213141516171819202122232425262728293031

Year Year20002001200220032004200520062007200820092010201120122013201420152016201720182019202020212022202320242025202620272028

First Meal Type: Please Select a MealBreakfastLunchDinner

Date of Last Meal:

Month MonthJanFebMarAprMayJunJulAugSepOctNovDec

Day Day12345678910111213141516171819202122232425262728293031

Year Year20002001200220032004200520062007200820092010201120122013201420152016201720182019202020212022202320242025202620272028

Last Meal Type Please Select a MealBreakfastLunchDinner

Special Meal Requests (please select all that apply):

Beverage Service

Luncheon

Reception

Banquet

Box Lunch

Other

Most Recent Campus or Facility Used:

Questions/Comments/Other requests?

How did you hear about us? *

Alumni

Conference Website

Chamber of Commerce

Friend / Family

CWU Staff / Faculty

ACCED-I

RCMA

Unique Venue

Other

Other:

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