SCACPA Chapter Seminar/Event Set Up Form Survey

Welcome to the Chapter Seminar/Event Set Up Form and thank you for helping us stay organized by submitting your event electronically!

DIRECTIONS: Complete the form below, noting fields marked with an asterisk (*), which are required.

NEXT STEPS:
* Remember CPE seminars require review and approval of the CPE Department and sometimes CPE Committee. It may take up to two weeks to receive approval.
* Also, postcards and brochure require a two week notice from the time you provide information to SCACPA.
* The chapter leader will receive a test link to the SCACPA Web site with a request to test register yourself before we promote the event electronically and via print publications.
* As always, if you have questions, concerns or comments, contact Sandra Oxner at soxner@scacpa.org or (803) 791-4181 ext. 112.

1. Select Your Chapter:

Select Your Chapter: Catawba (CA)

Central (CE)

Coastal (CO)

Foothills (FO)

Grand Strand (GS)

Pee Dee (PE)

Piedmont (PI)

Sea Island (SI)

2. BASIC EVENT INFO

BASIC EVENT INFO Your Name:
E-mail Address:
Name of Seminar/Event:
Event Date:
Registration Open Time (typically 30 minutes prior to start time):
Start Time:
End Time:
Facility:
Address:
City/State/Zip:
Facility Sales Contact Name:
Telephone:
E-mail Address:
Chapter Leader:
Chapter On-Site Leader:
Ship Event Materials To:
Ship to Address (no PO Boxes, please):
City/State/Zip:

3. Meals/Breaks Included with Registration (select all that apply):

Meals/Breaks Included with Registration (select all that apply): No meals provided Continental Breakfast (Cold) Hot Breakfast	Morning Snack Hot Lunch Cold Lunch	Afternoon Snack Water/Coffee Service Soda Service
Other (please specify)

4. Seminar Description/Learning Objectives:

Seminar Description/Learning Objectives:

5. CPE INFO (FOR APPROVAL BY SCACPA CPE DEPARTMENT/COMMITTEE)

CPE INFO (FOR APPROVAL BY SCACPA CPE DEPARTMENT/COMMITTEE) Number of credit hours:
Credit Area:
Credit Level:
Discussion Leader/Speaker Name:
Honorarium/Engagement Fee:
AV Needs:
Accommodations Information/Requests:
Other Special Needs:

6. Discussion Leader/Speaker Bio & Credentials:

Discussion Leader/Speaker Bio & Credentials:

7. Manuals/Handouts to be prepared by:

Manuals/Handouts to be prepared by: SCACPA	Chapter	Speaker	Other
Other (please specify)

8. Registration Fee Schedule: Please note - an Early Bird discount of $25 applies to all CPE seminars and is valid until three weeks prior to your event. Please take this into consideration when planning your fee schedule.

Registration Fee Schedule: Please note - an Early Bird discount of $25 applies to all CPE seminars and is valid until three weeks prior to your event. Please take this into consideration when planning your fee schedule. Standard/Non-Member Fee:
Chapter Member Fee:
Early Bird Discount (if applicable):
AICPA Discount (if applicable, $30 per member):
Complimentary Registrations (Chapter Officers, SCACPA Board, SCACPA Staff, etc.)

MARKETING REQUESTS
Please note: the Chapter Connections E-Newsletter is distributed as needed 1-2 times monthly. Upon special request, we may send an additional email to promote an event with low registration, however, please allow 3-5 business days for e-mail development.

9. CPA Report Magazine

CPA Report Magazine Second Edition 2012 (March 15 Deadline - Mail Date May 1)

Third Edition 2012 (June 15 Deadline - Mail Date - August 1)

Fourth Edition 2012 (September 15 Deadline - Mail Date November 1)

First Edition 2013 (December 15 Deadline - Mail Date February 1)

10. Current Assets E-Newsletter

Current Assets E-Newsletter February

March

April

May

June

July

August

September

October

November

December

January

11. Print Promotional Piece

Print Promotional Piece Postcard (design, print, mail out and postage to be determined) Brochure (design, print, mail and postage to be determined)	No print piece for this event
Other (please specify)

12. SPECIAL REQUESTS:

	Yes	No
SCACPA staff make hotel/facility arrangements	*SPECIAL REQUESTS: SCACPA staff make hotel/facility arrangements Yes	SCACPA staff make hotel/facility arrangements No
SCACPA staff make speaker arrangements	SCACPA staff make speaker arrangements Yes	SCACPA staff make speaker arrangements No
SCACPA staff manage on-site registration	SCACPA staff manage on-site registration Yes	SCACPA staff manage on-site registration No
SCACPA staff attend event	SCACPA staff attend event Yes	SCACPA staff attend event No
PAC-Backer Ribbons	PAC-Backer Ribbons Yes	PAC-Backer Ribbons No
Educational Fund Ribbons	Educational Fund Ribbons Yes	Educational Fund Ribbons No
Will you have sponsors?	Will you have sponsors? Yes	Will you have sponsors? No
Is this a Business Meeting?	Is this a Business Meeting? Yes	Is this a Business Meeting? No

Other (please specify)