EVENT DATE:  example: Sat., Sept. 4
         EVENT TIME:  if applicable
         EVENT NAME: 
  EVENT DESCRIPTION: (60 word maximum)
                     
         EVENT TYPE: 
                     (i.e., conference, trade show, promotion, etc.)
     EVENT LOCATION: 
                     
    EVENT PHONE No.:  (include area code)
     EVENT WEB SITE: 
	(IMPORTANT: If the event URL is long, please go to tinyurl.com and create a short one)
EVENT EMAIL ADDRESS: 

CONTACT INFO for ADMINISTRATIVE USE: (will not display:)
ORGANIZATION NAME: 
   STREET ADDRESS: 
                   
             CITY: 
            STATE: 
              ZIP: 
     CONTACT NAME: 
        JOB TITLE: 
    EMAIL ADDRESS: 
        PHONE No.: 
                    (include area code)

  COMMENTS OR SUGGESTIONS TO US (not to be displayed):