Event Request Form

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Your Name

Your Name*

Email Address

Email Address*

Your Committee

Your Committee*

Event Title

Topic

Event Description

Event Type (who should see this event?)

Anyone can see and register for the event

Registration required, but anyone can see event

Registration required, only members can see event

No registration, everyone can see the event

No registration, display only to members

Maximum number of participants

Event Date

Date of Event*

Event Location or Medium

Physical Address or videoconferencing software/link

Start Time of Event

Start Time*

End Time of Event

End time*

Event already approved by BOD member?

If yes, which one?

Choose BOD member

Additional Notes?

Enter any additional notes here

NOTE: Form submissions do not accept file uploads. If you have a file to attach, please email it separately to vp-communications@pmicic.org. Thank you!