Environmental Services Request

Name of event:	*
Purpose of event:
Event sponsors/organizers:
Type of event:		Conference session Festival Lunch and learn Neighborhood meeting School, church or civic presentation Other
Event date:	*
Event start time:	*
Event end time:	*
Location name:	*
Address:	*
City:	*
State:	*
Zip:
Contact person:	*
Title:
Organization:
Phone:	*
E-mail:	*
Type of services requested (speaker, materials, etc.):	*
Topics of interest:	*	Air quality Alternative transportation Bicycle/pedestrian issues Greenways/Trails/Parks Recycling/waste reduction Water quality
Other topics?
Estimated number of attendees:	*
Age range (seniors, adults, adolescents, children):	*
Is there a fee for us to participate? How much?	*
Set up time:
Will assistance be provided?
Tear down time:
Organizers will provide (table, chairs, tent, electricity, laptop, projector, screen, etc.):	*
MARC will need to provide:	*
Has a MARC program participated in this event before?		Yes No
If yes, please describe:
Has a MARC program participated in another event with this organization in the past?		Yes No
If yes, please describe:
Questions or comments:
Type this code:	*