FIRST Choice Date:
FIRST Choice Time:
SECOND Choice Date:
SECOND Choice Time:
THIRD Choice Date:
THIRD Choice Time:
Number of People Expected to Attend:
Will you be supplying and utilizing A/V?
If yes, what other A/V support can we provide?
Please provide detailed information about your event in the boxes below.
I. Program Abstract: Please provide a brief summary of your program and indicate any special features (i.e. performers, food, etc).
II. Program Goals: Please list your program goals and how they relate to Earthstock.
III. Involvement. Indicate any and all co-sponsoring groups and describe each group’s role in the program.