Please submit this form to the Steering Committee one month prior to event. General Information Chairperson name * The chairperson is the person responsible for this event. Contact email * Date of Event * Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Day Day12345678910111213141516171819202122232425262728293031 Year Year20172018 Requests for this fiscal year. Event start time * Hour hour123456789101112 : Minute minute000102030405060708091011121314151617181920212223242526272829303132333435363738394041424344454647484950515253545556575859 am pm Rental begin time. Hour hour123456789101112 : Minute minute000102030405060708091011121314151617181920212223242526272829303132333435363738394041424344454647484950515253545556575859 am pm Include total amount of time needed for setup and cleanup. Rental end time. Hour hour123456789101112 : Minute minute000102030405060708091011121314151617181920212223242526272829303132333435363738394041424344454647484950515253545556575859 am pm Include total amount of time needed for setup and cleanup. Recurring event dates. If this is a recurring event, please list specific dates. Example: 11/11/16, 11/8/16, 12/13/16, 1/10/17 etc. Name of Event * Description and reason for the event. * Location Of Event * Example: Center Estimated number of attendees * Advertising and Financial Type of Advertising requested. Be sure to include exact copy information and photo below. Website Calendar Facebook Event Twitter eblast Sunday Announcement Sheet US Mail Printing Do you need an email address assigned to your event? Example: aidswalk, theater, event, baseball...@DignityNY.org Include Copy information for advertisement * A CTA (call-to-action) with supporting contact information – Say exactly why people should attend this Dignity event and what it will do for them. The field below has the option to upload a document or photo. (If no advertisement is required write "None") Copy info or small photos may be uploaded Funding Requirements * What funding is needed for this event? (If no funding is required write "None") Refreshments $ Other List any other budgeted items and projected expense. Other needs Center equipment and furniture needs. Table and chairs provided by room size. See additional requirements chosen below. Do You Need any of the following for event? 5’ rectangular tables Small round tables (24” diameter) Large round table (60” diameter) Cocktail rounds (24” diameter / high top tables Mobile sound system Microphone Podium Mobile projection screen Auditorium sound system Auditorium projection with screen Easel with pad and markers Coat rack and hangers Table cloths, rolling partition, TV /DVD player Multiple items can be selected. List any other items that are not listed above. Anything else we need to know? The steering committee will receive your request and review it at our next meeting, the 2nd Tuesday of the month. You are welcome to attend. CAPTCHAThis question is for testing whether or not you are a human visitor and to prevent automated spam submissions.