Event Info Form Event Sponsor/Organization Contact Name Contact Position/Title Contact Email Contact Birthday Sponsor Address, City, State, Zip Mobile Number (###) ### #### Work Number (###) ### #### Date of Your Event Name and Address of Event Location Type of Venue Event Name Event Theme If we could do anything to contribute to the success of your event, what would it be? Event Contact Person Event Contact's Phone Number (###) ### #### Number of Times Speaking Name(s) of Talks Speaking Time(s) and Length of Talk(s). If this is for a conference, please note the session times. Dress Code Name(s) of Other Speaker(s) Audience Demographics Approximate Projected Attendance Speaking Details Necessary Arrival Date Arrival City/Airport Time by Which Speaker Must Arrive Departure Date/Time Lodging Details (Note: If host is responsible for Homer's hotel accommodations, please note details: Name, address, confirmation #) Special Requests/Information Thank you! Your application is being reviewed. A representative will reach out to you to set up an interview to see if this course will be a good fit for you. You’re Awesome!
