Company Name:
Planner
Title
Decision Maker
Title
Address:
City:
State:	Zip:
Phone:
Fax:
eMail:
Specifics
Type of Meeting:
Dates Preferred:
Number of Attendees
Number of Guest Rooms Needed
Types of Rooms Requested
Spouses?	Yes No
Type of Meeting Site Preferred:	Suburban Hotel City Hotel Resort Conference Center Other
Serious Planning will Begin
Site Decision Will be Made In:	1 to 2 Months 2 to 3 Months 3 to 6 Months 6 to 9 Months 9 to 12 Months Other
Decision Date on Site Selection:
Buy Decision
General Session (Meeting Room Setup)
Number of Breakout Rooms Needed
Do You Hold any Banquet, Catering or Special Functions?	Yes No
Additional comments