Afro Urban Society Event Request
Contact Name (First, Last): *
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Organization Name (if applicable):
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E-mail Address: *
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Phone #: *
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Best Way/Time to contact you:
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Tell us a bit about yourself/organization: *
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How did you hear about us? *
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Performer/Presenter Type *
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Engagement Request Type *
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Event Name *
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Event Date *
MM
/
DD
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YYYY
Event Time *
Time
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Performance Start Time *
Time
:
Performance End Time *
Time
:
Length of Engagement: *
How Long?
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Location Name & Complete Address of Event: *
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Describe your Event & Audience/Participants *
What are the goals? Who are the organizers? Who is the event for/about?
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The experience you would like for us to create at your event *
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How many participants/attendees? *
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Is this a ticketed event? *
What is your budget for our engagement? *
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Other Engagement *
Will there be other entertainment, speakers, activities or facilitation happening at your event? Please describe.
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Questions, Notes, ETC
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