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NBC 4 Person Requested: *
Organization/Group Name: *
If applicable, which non-profit organization does the event benefit? *
Event Name: *
Date Of Event: * Select Date
Time of Event *
Estimated Attendance: *
Attendance Makeup: (Adults, children/students, general public, business professionals) *
Brief Description Of Event: *
What Will The Representative Do At Event? (Please be very specific as to the duties you would ideally like performed at your event. Please note we do not allow any of our talent to act as an auctioneer for any functions.) *
Will A Script/Talking Points Be Provided? *Yes
No
Event Location: *
Directions To Event: *
Parking Details: *
Will Valet Parking Be Provided? *Yes
No
Is The Event Inside Or Outside? *
Dress Attire of Event: *Casual
Formal
Informal
Business
Other
Bio or Photo Needed? *Yes
No
E-mail Address: *
Contact Person: *
Phone Number: *
Cell Phone: *

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