Greenelight Professional Development Preliminary Booking Form

Preliminary Booking Information

Presentation:
Time From:
Time To:
Date(s):
Location:
Lodging:
Fee:
Call for value arrangements. A 50% deposit is payable and due on booking the program. The balance is due on-site prior to the start of the program.
Expenses:	Reimbursement for airfare, hotel, and travel expenses can be handled in the following manner:
Client May:	Pay Expenses Following The Program Set Up Prepayment of Expenses An Estimate may be made and paid with fee
Additional Information: (please initial or note change)

	Airfare: Capiz will book roundtrip (coach) airfare from Omaha, Nebraska Airfare: Client will book roundtrip (coach) airfare from Omaha, Nebraska
	Lodging: Capiz will book lodging Lodging: Client will book lodging
	Handouts: (please check one) Our Organization will provide program handouts Capiz will provide program handouts
	Estimated number of Attendees:
	Photo: (please check if you one) Black and White Color
	A/V: Wireless Lavalier Microphone (with wired backup) Table: Draped table in front of room Taping: No audio or video taping without written permission
	Tools: Capiz may display training and educational tools that support the learning process Yes No
Misc. Notes:
Date:
Organization:
Contact Name:
Contact Email: