Salutation: Mr. Mrs. Ms.

First Name:

Last Name:

Title:

Company:

Address 1:

Address 2:

City:

Province/State:

Country:

Phone:

Fax:

Company Website:

Email: *

Preferred Method of Contact: Email Phone Fax

Event Name:

Event Date (Start) Start Date

Event Date (End) End Date

Estimated Attendance: 0-25 26-50 51-75 76-100 101-150 151-200 201-250 250+

Is the meeting in Niagara Falls? Yes No

Hotel/Location:

Do you require meeting space or accommodations? Neither Both Meeting Accommodation

# of accommodation rooms

# of meeting rooms

# of breakout rooms

Do you require food and beverage catering? Yes No

Is a meet and greet needed? Yes No

# of people on main arrival/departure day:

Other Services requested: Tour and Ticket Desk Staff Registration Staff Team Building Events Youth Programs Speakers Unique Leisure Activities Discount Attraction Tickets Dining in the Niagara Region Themed Events/Entertainment Special Events Guest/Spouse Tour Programs Shuttle Service VIP Trasportation Interpreters Registration/Meeting Products Custom Gift Baskets

Additional Comments: