Request for Information

*Required Field

Your Information

1. First Name*Last Name*
2. PhoneFax
3. Email*
4. Are you a contracted planner for this event?
   YesNo

Company Information

1. Company Name (User of the Facility)
2. Address
3. City
4. StateChoose OneAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTenneseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming
5. Zip
6. Company (User) PhoneCompany (User) Web Address
7. Is Company (User)
   ProfitNon-Profit
8. Is Company (User) Incorporated?
   YesNo
9. If so ‚ in what State?
10. Company (User) Federal TaxID#

Event Information

1. Proposed Event Type/Name
2. Date/Time(s)
3. Daily Expected AttendanceTotal Expected Attendance
4. Insurance CarrierCharlotte Convention Center requires all users of the facility to provide proof of insurance including Commercial Liability, Workers' Compensation and Auto
5. Insurance Contact
6. Do you require alcoholic beverages during the event?
   YesNo
7. Do you require food to be serviced during the event?
   YesNo
8. Do you require audio-visual services during the event?
   YesNo
9. Please provide the nature of the event and its attendees
10. Will this be a public / ticketed event?
    YesNo
11. How will admittance be controlled? (Check all that apply)
    Advanced Ticket SalesOn-site Ticket SalesPre-registrationOn-site Registration Invitation

Past Events

During the past (3) years under the current company name, please list a minimum of (3) events of a similar nature for all categories listed below:

Event 1

1. Event NameType of Event
2. DatesActual Attendance
3. Location/Facility
4. Facility ManagerFacility Contact Phone

Event 2

1. Event NameType of Event
2. DatesActual Attendance
3. Location/Facility
4. Facility ManagerFacility Contact Phone

Event 3

1. Event NameType of Event
2. DatesActual Attendance
3. Location/Facility
4. Facility ManagerFacility Contact Phone

1. Verification*
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