Event Name* Recurrence One Time Event Meets Weekly Meets Monthly Date(s) of Event*Please enter date(s) as mm/dd/yy OR enter start date (mm/dd/yy) and nature of recurrence (e.g. 01/01/16, every Monday through 01/01/17).If scheduled regularly, please add any other details, as needed.Event Starting Time/ Set Up Time* Event Finishing Time Location (Desired) How many expected? Contact Person* First Last TelephoneEmail Address Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code CellContact Staff Person Equipment required (tableware, AV, etc.)Displays required (easel, poster, table display)Child care needed? Yes No Number of Children Ages Additional Requests or CommentsOrganization/Committee
