DAT Event / Program Proposal Form

Committee Name:

Point of Contact for event:

Phone:

Event Name:

Date:

Time:

Estimated # of attendees:

Location (be specific):

Is this a recurring event? Please circle one:
YESNo

How often:

Purpose of event:

Will you be raising funds at this event? Please circle one:
YESNo

Do you require set up? Please circle one::
YESNo

If yes, please provide details of what set up you would need:

Cost of event, please circle all that apply:
SPONSOREDNO COST

BUDGET REQUESTED:

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