Event information submitted by:

E-mail address:

Date(s) of event (e.g., October 13, 2004):

Title of event:

Event location (building, street information):

City / state location of event (e.g., Burlington, VT):

Start time (required information - must be time of day; example - 8 a.m.):

End time (required information - must be time of day; example - 5 p.m.):

Registration fees:

Registration deadline:

Event contact person:

Contact address (include street, city, state, zip code):

Contact phone number (include 800#'s & phone extensions):

E-mail address:

 

ADA - copy the statement in brackets, change the name, phone # and date info [To request a disability-related accommodation to participate in this program, please contact [ Firstname Lastname ] at [ 802-xxx-xxxx or 800-xxx-xxxx ] by [ Month Day, Year ] so we may assist you.]:

 

URL for event web site or online brochure:

OR