Survey - Organize An Event

Host Your Own Event

Question - Not Required - Event Name:

Question - Not Required - Group Name (Optional):

Enter Your Information:

*

Name:

First Required	Last Required

*

Email: Required

*

Street 1: Required

*

City/State/ZIP:

City Required	State Required	ZIP Required

*

Phone Number: Required

Yes, I would like to receive e-mail from New Horizons

Remember me. What's this?

Question - Not Required - Company Name (Optional):

Event Information:

Question - Not Required - Date of Event:

Month

Day

Year

Question - Not Required - Description of Event (250 characters or less):

(Maximum response 255 chars, approx. 5 rows of text)

Question - Not Required - Location of the event (please include name, address and city):

(Maximum response 255 chars, approx. 5 rows of text)

Question - Not Required - Event is:

Question - Not Required - Estimate number of participants:

Question - Not Required - Is this a first time event?

Question - Not Required - If possible, would you like someone from New Horizons to attend your event?

Question - Not Required - How will the event be publicized? (press release, advertisement, promotional flyers)

(Maximum response 255 chars, approx. 5 rows of text)

Budget/Fundraising Information

Question - Not Required - Total Projected Revenue (Enter amount IE: $5,000):

Question - Not Required - Total Projected Expenses (Enter amount IE: $2,000):

Question - Not Required - Individual ticket price (enter amount IE: $35.00):

Question - Not Required - Please list all businesses you intend to solicit for sponsorship or in-kind contributions:

(Maximum response 255 chars, approx. 5 rows of text)

Support Needed

Question - Not Required - Please check all the items/support you will required from New Horizons.

	Acknowledgements to donors
	Banking Support
	Logo
	New Horizons Brochures

Question - Not Required - Other: