Correspondent (Point of Contact) Information

First Name:

Last Name:

Your Position/Role:

Primary Email Address:

Primary Phone #:

Secondary Phone #:

Organization Information:

Organization Name:

Organization Type:

Address:

Address 2:

City/Province:

State:

Country:

Zip/Postal Code:

Office Phone #:

Fax Phone #:


Details


Name of Event:

Date of Event
(mm/dd/yyyy):
  

Number of days you will need Above and Beyond present:

Time event should conclude:

Amount of time allotted to Above and Beyond for performance:

Is there a power source available: Yes No

Are Loud Sound Equipment provided: Yes No

Are Wireless Microphones provided: Yes No

Are lights provided: Yes No

Is there a video/camera person(s): Yes No

Estimated number of participants/observers:

Age range of target audience:

Specific locale or building at facility to drop off and pick up equipment:

Auxiliary information you need:


Physical Address of event (if diff. from org. mailing address)


Address:

Address 2:

City/Province:

State:

Country:

Zip/Postal Code:

Phone #:


Travel Information


Airport Name:

Airport City/Province:

Closest proximity to event location from airport:

Distance from airport to event (miles/ ETD):
Directions:

Do we need a Rental Car Yes No

Do you provide Personal Transportation Yes No




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