Event Event Location (provide address that appears on GPS) Event Address Sponsoring Agency Contact Person Mailing Address Phone # Day Phone # Evening Cell Phone # Email Address: Fax # Requested Date Alternate Date Arrival Time Beginning and End Times MWV Will Be Met By Contact Number Event Type Awards CeremonyBanquetConferenceClassroom VisitSchool AssemblyParade*Local PageantSchool PresentationOther* Event Type Other Indoors Outdoors Event Attire Business SuitBusiness CasualCocktail AttireSporty CasualBlack Tie Will MWV be expected to give a speech? YesNo Topic of Speech Length of speech Will MWV be expected to make a talent presentation? YesNo If Yes how many numbers? Description of MWV's duties (eg. emcee/guest/presenter/etc): Audience Description AdultSchool GroupMixed If School Group what Grades? Are press conference radio and/or TV appearances planned? YesNo If Yes provide details: If lodging is needed will your organization make those arrangements? YesNo Name of Establishment Phone # of Establishment Establishment Address Confirmation Number If organization not making lodging arrangements please provide a listing of establishments in your area with phone numbers The appearance fee that is agreed upon is: Electronic Signature (enter name) Signed Date Security code:   * Do not enter anything in this field: