Continuing Education and Conference Center: Request for Information

Thank you for your interest in the Continuing Education and Conference Center. We look forward to serving you in the near future.

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Please provide the following:

First Name*

Last Name*

Organization*

Title*

Street Address*

City*

State*

Zip*

Phone Number*

E-mail Address*

Please reenter E-mail Address

Preferred date

Alternative date

Time of program/event

Program/event length (days)

Program/event name

Total attendees

Number of meeting rooms needed

Breakout space needed? (Y or N)

Number of people per room

Food service needs including breaks

Additional meeting room needs including audio-visual equipment, parking, special considerations, etc.

General comments or questions