2012 Seminar Request Form

This form must be received January 20, 2012.

If you have any questions you may call (206) 283-9545 or TOLL FREE (866) 238-3250.

SEMINARS ARE SCHEDULED ON A FIRST-COME, FIRST-SERVED BASIS AND WILL BE MONITORED BY RALLY STAFF. ALL CONTENT MUST BE INFORMATIVE AND EDUCATIONAL.  SALES-ORIENTED CONTENT IS UNACCEPTABLE. A BRIEF SEMINAR DESCRIPTION AND SPEAKER BIO MUST BE INCLUDED WITH REQUEST FORM. INCOMPLETE, ILLEGIBLE AND/OR LATE FORMS WILL DELAY PROCESSING.

SCHEDULING OF MULTIPLE SEMINARS AT ANY 2012 RALLY VENUES CANNOT BE GUARANTEED.

PLEASE UNDERSTAND THAT ACCEPTANCE OF THIS FORM IS SUBJECT TO APPROVAL.

ASSIGNED SEMINAR DAY AND LOCATION WILL BE SENT VIA E-MAIL.

Items below marked with an asterisk (*) are required.

1. Company Name(*)
2. Contact(*)
3. Name of Presenter(*)
4. Address(*)
5. City(*)
6. State/Province(*)
7. Zip Code(*)
8. Phone Number(*)
9. Cell Phone / Phone at Rally(*)
10. Email Address(*)
11. Seminar Title And Description(*)
12. Brief Bio of Speaker(*)
13. Room set-up includes wireless (lapel-type) microphone, screen and podium. Please check the additional equipment needed for your seminar below. Service charges will apply for all extra equipment ordered. Late fees will be assessed for any requests made after January 20, 2012.
14. Additional Equipment Needed
15. Slide Projector Overhead Projector LCD Projector VCR/TV Other
16. If you answered Other above, please explain
17. Multiple seminars at any of the three 2012 Good Sam Rallies will not be guaranteed.
18. Please enter the verification code

 

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