14 Bowl Game Ticket Information
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Student-Athletes Community Service Program

Required Fields are in Bold

Organization Information
Name of Organization
 
Street Address
 
City
 
State
 
ZIP Code
 
Contact Information
Contact Name
 
Daytime Phone
 
Cell Phone
 
Email Address
 
Event Information
Name of Event
 
Date of Appearance/Event
 
Location of Appearance/Event
 
Appearance/Event Address
 
Appearance/Event Location City
 
Appearance/Event Location ZIP Code
 
Appearance/Event Major Crossroad (Street 1)
 
Appearance/Event Major Crossroad (Street 2)
 
Name of Contact Person on-site at Appearance/Event
 
Cell Phone for Contact Person on-site (in case of emergency)
 
Time of Event (time the event starts)
 
Time of Speaking/Appearance (Time you would like the speaker to start)
 
Length of Presentation (i.e. 30 minutes)
 
Type of Appearance/Event
 
If you selected "Other" for event type, please describe event
 
Topic of Presentation (Please describe EXACTLY what you would like the speaker to do and/or the speaking topic)
 
Age Range of People Benefiting (i.e. 5-60 years)
 
Number of People Attending
 
Number of Minorities Benefiting (This figure helps us determine minority outreach efforts)
 
Gender Breakdown of those Attending (by number)
Male
 
Female
 
Other Comments
 
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