2010 ANNUAL MEETING ROOM REQUEST FORM by malj

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									                2011 ANNUAL MEETING                                       APHA OFFICE USE ONLY
                                                                                                      RelOrg Mtg RequestForm 11


                ROOM REQUEST FORM                                         In-House Number: _____________

                                                                          Hotel: ____________________ Room: ________________

EARLY DEADLINE: April 15, 2011                                            Date Received: ______________ No. Rec’d: ___________
FINAL DEADLINE: Aug. 12, 2011
Please type or print neatly:
Day                          Date:                                           Time From:                    Time To:
(Day and time requested is not guaranteed, you will be contacted if the time slot is not available.)
Primary Sponsor:
Event Title:
Estimated attendance (Be as accurate as possible):
Planning Chairperson
Name:
Telephone:                                                                E-mail:

TYPE OF MEETING: Check all that apply

    PRIVATE function*: Please do not list in program – event will not be listed on the APHA Website or in the program
             Breakfast            Lunch           Dinner        Reception            Other                 Not Food Function

    Business Meeting*: Set Conference Style for 25 – MAX
             Breakfast            Lunch                Dinner                Other                Not Food Function

    Business Meeting*: Set Theater Style for number of persons indicated above
             Breakfast            Lunch                Dinner                Other                Not Food Function

    Social Hour/ Social Event*:
             Breakfast            Lunch           Dinner        Reception            Other                 Not Food Function

*Sponsor responsible for all planning and costs

         APHA will place you in contact with the catering or banquet manager in July 2011 for all food functions.

ROOM SET-UP AND EQUIPMENT
 “Special” room set-ups may be available, by advance request only. Special room sets may require additional fees.
 APHA has the right to leave AV equipment, podiums and head tables in rooms during Related Organization events.
 Related Organizations will incur additional charges for equipment added on site.

    Reception Style (available for social hours) – Head Table                  Yes    No
    Theater Style (available for business meetings larger than 25. Head table for 6 will be provided)
    Roundtables : Number of tables required for food function:
    Conference Style (no more than 25 persons, larger will be placed in theater style set)
    Lighted Lectern
   Wheelchair or Mobility Accessibility Needed for speakers. Notes:


*Bill to (will be billed to the primary sponsor contact person on the application unless otherwise noted here
Name:
Address:

Phone:                                                          E-mail:

								
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