Merrillville Conference Service Request
Contact
Company Name
First Name
Last Name
Email
name@domain.com
Phone
Company Address
Street Address
City
State
Please select...
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District Of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Puerto Rico
Virgin Island
Northern Mariana Islands
Guam
American Samoa
Palau
Zip
Emergency Contact
Emergency Contact First Name
Emergency Contact Last Name
Emergency Contact Phone
Meeting Information
Title of Meeting
Date of Event
Time Event Begins
Time Event Ends
Approximate Number of People
Room Size Needed
Small (4 - 6 Guest)
Regular (4 - 30)
Large (31 - 110)
Tax Exempt?
Yes
No
Equipment Rental
Smart Cart: includes: screen, desktop, laptop connections, classroom speakers, LCD Projector, DVD player and podium
Yes
No
Wireless Internet
Yes
No
Flip Chart
Yes
No
Conference Phone
Yes
No
Sound System/Microphone
Yes
No
Beverage Services
Coffee
Yes
No
Individual Soda Cans
Yes
No
How many?
Special Requests
How Did You Hear About Us?
Contact Information