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Mt. Washington Conference Center
5801 Meeting Request Form
5801 Meeting Request Form
Department:
(Required)
Date:
(Required)
MM slash DD slash YYYY
Planner for Meeting:
(Required)
Office Phone:
(Required)
Email:
(Required)
On-site Contact Name:
(Required)
On-site Contact Cell Phone:
(Required)
Job Title
(Required)
Date(s) Meeting Space Needed:
(Required)
Expected Total # of Attendees:
(Required)
Name of Meeting (to be posted on door):
(Required)
Room Set-up & A/V Needs
Room Set-up (please choose one): *Reference Capacity Chart*
(Required)
Conference
Theater
Rounds
U-Shape
Hollow Square
Classroom
A/V Needs in Primary Meeting Space (please check all that apply)
(Required)
LCD
Screen
Microphone
Flipchart
None
Please List the Quantities Needed for Each Item Selected Above:
(Required)
# of Breakout Rooms Needed:
Breakout Room Set-up (view options above)
# of Attendees in Each Breakout Room:
A/V Needs in Breakout Rooms (please check all that apply):
LCD
Screen
Microphone
Flipchart
Please List the Quantities Needed for Each Item Selected Above:
Packages
Please Select One of the Following Packages (all packages include meeting space, presentation aids, audio-visual equipment, and complimentary parking):
(Required)
Package A: The Daily Meeting Package (DMP) includes: Three (3) meals/snacks per day in designated meeting space; Boxed Continental Breakfast, Lunch, PM Break. All meals include 1 bottled beverage.
Package B: The Daily Meeting Package (DMP) includes: Three (3) meals/snacks per day in designated meeting space; Breakfast Buffet, Lunch Buffett, Buffet-Style PM Break. All meals include 1 bottled beverage.
Meeting Timelines: Please Enter the Date and Total # of Attendees for Each Day:
Monday
(Required)
Tuesday
(Required)
Wednesday
(Required)
Thursday
(Required)
Friday
(Required)
Please Give a Rough Timeline of Events:
Client Arrival
(Required)
Event Start
(Required)
AM Break Start
(Required)
Lunch
(Required)
PM Break
(Required)
End of Event
(Required)
Additional Information
Would You Like Any Additional Beverages Sold A La Carte? The Following Services Are Available:
Coffee/tea by the gallon (list quantity below)
Additional soda/water (list quantity below)
Quantities for Additional Food and Beverage:
Would You Like This To Be a Zero-Waste Event (compostable disposables)?
(Required)
Yes
No
Do You Require Any Additional Items for Your Meeting?
CAPTCHA
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