CMS Family and Community Services

Back to School Event Request Form

Name of Organization

Date of EventTime of Event

Address of Event

Sponsor Contact NameSponsor Phone Number

Sponsor Contact Email Address

Estimated Number of AttendantsIndoor or Outdoor Event

Describe Your Event

(Include target audience information and ultimate goal of your overall event and our participation; include specifics of time for speaking requests)

Back to School Event Services offered by Family and Community Services-Parent University

(Place an X by your service need)

_____ Workshop Request (Back to School Info Session: 45 minutes)______Materials Request

_____ Department Booth______Speaker Request

Certain event requests require equipment and set up. Do you have the following (check all that you have)

1 | All events should be submitted at least 2 weeks before the actual event and no later than August 1, 2011.

____ Laptop

____ LCD Projector

____ Microphone

____ Facilities for a Class (Indoors)

____ Projection Screen or Clear Projection Area

____ Table for Booth

1 | All events should be submitted at least 2 weeks before the actual event and no later than August 1, 2011.

Instructions & Clarifications for Completing the Event Request Form

  1. Enter all of the information requested on the form provided. You may extend the pages to enter all of the information that you would like us to have and save your document as you chose to do so. You have the option to type or write and scan the document back to us.
  1. If you select a speaker request, you want someone from our department to talk more about Family and Community Services - Parent University and what we do and offer throughout the year. A workshop is different in that, you would like an information session that can be tailored to what you provide in your description of the event. Speaker Requestare 10-20 minutes and Workshop Request are 45 minutes to an hour.
  1. Submit the completed form and send it back as an attachment at least 2 weeks in advance of your event and no later than August 1, 2012.
  1. Do not attempt to fax this form or call to have this form completed. We want full confirmations and communications through e-mail for our records and yours. If you have any issues with sending this form, please call 980-343-6256.
  1. In your email submission, the subject can read: Back to School Event Request. You will receive a confirmation within 48 hours that your submission has been received and a confirmation within a week from your submission of the request if we are able to provide services.

Thank you for partnering with us and we look forward to working with you!

CMS Family and Community Services Department

1 | All events should be submitted at least 2 weeks before the actual event and no later than August 1, 2011.