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Name of Event:
*
Requested Date of Event:
*
Number of Attendees:
*
Requested Start Time:
*
Requested End Time:
*
Requested By:
Name
*
First and Last Name
DAC Email
*
Meeting Details:
Type of Room Setup:
*
Classroom
Conference
Crescent Rounds
Hollow Square
Round Table
Theater Style
U-Shaped
Custom/Other
Type of Room Setup Other
*
Food and Beverage Needed?
*
Yes
No
1 - Preferred Time
1 - F/B items for this time
2- Preferred Time
2 - F/B items for this time
AV Needs
Screen
LCD Projector
Overhead Projector
Flipchart
Podium/Microphone
White Board
Handheld Microphone
Wireless Microphone
Other
What will A/V be used for:
(Powerpoint, video with audio, bringing own laptop, etc)
AV Needs Other
*
Who Will Be Attending:
*
In House Employees
Members & Employees
DAC Members Only
Billing Charges
*
Commitee Expense
Clubhouse Expense
Members to Sign Chits
Special Billing #
Other
Special Billing #
Billing Charges Other:
*
Include any additional comments
100%
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