New Client Questionnaire

New Client Questionnaire

Fields marked with a * are required.

Your Contact Information

Your Name*

Phone Number*

Fax Number

Your Email*

Meeting Information

Meeting Name

Location

Preferred Date (MM/DD/YYYY)

Previous Registration Fee

Amount Assessed

Off-Site Events

Are there offsite events associated with this meeting?

 Yes No

If so, what type of events?

Which Nights?

Registration Information

Would you like registration materials assembled and mailed by us?

 Yes No

If so, who is our contact for approval of materials?

Would you like name tags for the meeting?

 Yes No

Would you like on-site assistance?

 Yes No

Hotel Accommodation Information

Method of Payment: MastercardVisaAmerican ExpressCredit ApplicationCheck

Hotel Preference

Hotel/Facility of Previous Meetings

Previous Sleeping Room Rate

Previous Date of Meeting (MM/DD/YYYY)

Preferred Location of Meeting

 Close to Airport Close to Restaurant Downtown Other

If you marked "other", please specify

Hotel Payment Options

 Individual Pays for Own Room Organization Pays for Sleeping Rooms

Are there any handicapped individuals that will be attending?

 Yes No

Names of the handicapped individuals

Would you like any special transportation arrangements?

 Yes No

Additional Information

Is there any additional information we should know?

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