Welcome to Greater Bridgeport, West Virginia

* denotes Required Field

Section I. Contact Information

Event Host: *
Event Name: *
Key Contact
Personal Title: *
Name: *
Job Title:
Employer:
Address: *

City: *
State: *	Zip: *
Phone: *
Fax:
Email Address: *
Website:
Contact Role: *	(check all that apply) Event Organizer/Planner Informational Contact Staff Volunteer Other:
Section II: Event Profile
Event Type: *	Board Meeting Convention Committee Meeting Customer Event Educational Meeting General Business Meeting Local Employee Gathering Product Launch Public Show Sales Meeting Shareholders Meeting Special Event Team-Building Event Trade Show Training Meeting Video Conference Other

Event Info:	Event Start Date: * End Date: *
	Alternate Start Date: End Date:
	Alternate Start Date: End Date:
	Alternate Start Date: End Date:
	Event Web Address:
	Anticipated Number of Attendees: *
	Anticipated Number of Hotel Rooms: *