Organization Name:
First Name:
Last Name:
Address:
Address 2:
City:
State:	Select State Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington Washington D.C. West Virginia Wisconsin Wyoming
Country:
Zip/Country Code:
Email:
Work Phone:
Cell Phone:
Fax:
Information Regarding Your Staffing Level
Staffing Level:	(Check each one that applies.)
	Meeting
	Manager/Coordinator Administrative Assistant Registration Assistant
	Event Production
	Producer/Coordinator Administrative Assistant Event Greeter - Host/Hostess
	Destination Management
	Meet & Greet Coordination Meet & Greet Staff Dispatchers Meet & Greet Shuttle Supervisor Step-On Guide
	Mobile Marketing
	Manager/Coordinator Administrative Assistant Registration Assistant
	Other Needs
	Exhibits Installation & Dismantle Incentive Travel Program Consulting Project Manager Web-based Solutions Experts
Start Date:
Assignment Length:
Hours/Days of work:
Number of staff needed:
Report to location:
Supervisor's name:
Position Description:
General Comments: