100 Club of Arizona Event Proposal Question Title * 1. Initial Contact Date (Required.) Date / Time Date Time AM/PM - AM PM Question Title * 2. Name (Required.) Question Title * 3. Name of Company (If Applicable) Question Title * 4. Title Question Title * 5. Mailing Address (Required.) Name Address City, State Zip Code Question Title * 6. Cell Phone Question Title * 7. Business Phone Question Title * 8. Email Address (Required.) Question Title * 9. Type / Name of Event Question Title * 10. Purpose(s) of Event Question Title * 11. Location/Venue Question Title * 12. Proposed date/time of event (Required.) Please enter proposed date and time. Date Time AM/PM - AM PM Question Title * 13. Proposed number of Attendees Question Title * 14. Estimated Cost for Attendees (if applicable) Question Title * 15. Information and Description of Event Question Title * 16. Estimated cost to the 100 Club Question Title * 17. Reasons for cost Question Title * 18. 100 Club Responsibilities - Volunteers needed? How many? Yes No If you answered YES - How many volunteers? Question Title * 19. 100 Club Information Table requested? Yes No Question Title * 20. 100 Club of Arizona Speaker requested? (If available) Yes No If you chose YES, How long will the speaker be needed? Question Title * 21. Percentage of proceeds to be donated to the 100 Club 0 100 Clear i We adjusted the number you entered based on the slider’s scale. Question Title * 22. How will the money be donated to the 100 Club (e.g. cash at event, check hand delivered after, check mailed after) If you have any questions or concerns, please email events@100club.org. Please call our office at (602) 485-0100 if you do not receive a response within 24-48 business hours. Thank you for your submission. Done
