ASHA 2008 Annual Convention - Function Room Space

2008 Request for Function Room Space

DEADLINE: MONDAY, AUGUST 4th, 2008

First name

Last name

Company name

Address

Address

City

State

Zip

Country

Phone

Phone Ext

Fax

Email

Group: [REQUIRED]
	Please note: One application must be completed for each function requested. Affiliated/Related Professional Organization (A/RPO) ASHA Board / Committee / Council / Task Force Division Exhibitor

Group Name: [REQUIRED]
	Please indicate your group name as you want it to appear in publications.

Confirm if this function should be published or not published [REQUIRED]
	Publish this function Do not publish this function

Preferred Date and Times: (enter your date and times in the fields below)
	Every effort will be made to accommodate your request within the constraints of Association policy and available space. We encourage you to schedule your events before and after Convention programming (generally 7:30am-5:00pm on Thursday, Friday, Saturday)

Date of Function: [REQUIRED]
	Please use this format for the date: mm/dd/yy

What time does this function BEGIN? [REQUIRED]
	Please use this format for time: 00:00 am/pm

What time does this function END? [REQUIRED]
	Please use this format for time: 00:00 am/pm

What time is function room needed for SET UP? [REQUIRED]
	Please use this format for time: 00:00 am/pm

Type of Function:
	Meeting Breakfast Luncheon Dinner Reception Other (specify below) If other, please specify:

Anticipated Attendance: [REQUIRED]

Desired Room Arrangement: [REQUIRED]
	Conference Set Theater School Room Round Tables Cocktail Tables Other (specify below) If other, please specify:

If you selected "Other" please upload your diagram.

Additional Specifications:

Charges for food and beverage, room changes, or additional specifications will be billed to you directly by the provider. (Food and beverage ordered through room service must be paid for on delivery.)

Audiovisuals [REQUIRED]
	Yes No If yes, please specify:

Elevated Stage [REQUIRED]
	Yes No

Standing Lectern [REQUIRED]
	Yes No

Food and Beverage [REQUIRED]
	Yes No

Head Table [REQUIRED]
	Yes No If yes, please specify number of persons:

Other
	Please specify:

Submit and Print
	After submitting your request, you will receive a confirmation and the option to print a copy of the form for your files.