Wufoo

Name * First Last
Name of Organization/Company *
Address *
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Email *
Phone Number * ### - ### - ####
Support You're Requesting
What type of support are you requesting? (Select all that apply) *
Event Marketing Event Sponsorship Event Ticketing Services Infrastructure/Operating (skip to next section) Ticket Donation

Marketing: Advertising through the MIDWESTIX network including web site, email and print properties.

Sponsorship: Cash contribution to the event.

Ticket Services: Pro-bono or reduced fee ticketing services for your event.
EVENT SUPPORT
Name of Your Event *
Date of Event * MM / DD / YYYY
Your event must be held between July 1st, 2011 and June 30th, 2012.
Time * HH : MM : SS AM/PM
Location of Event (include venue and city) *
ESTIMATED NUMBER OF ATTENDEES *
Description of Your Event *
Maximum Allowed: 300 words. Currently Used: 0 words.

Please give us a detailed description of your event including what will happen at the event, who will attend and why it's important for the scene you live and work in.
DETAIL WHAT MARKETING SUPPORT YOU NEED.
Maximum Allowed: 500 words. Currently Used: 0 words.
DETAIL HOW MUCH SPONSORSHIP MONEY YOU ARE REQUESTING AND DETAIL WHAT IT WILL BE USED FOR.
Maximum Allowed: 500 words. Currently Used: 0 words.
IF YOU'RE REQUESTING TICKETING SERVICES, DETAIL TICKET PRICES AND FULFILLMENT REQUIREMENTS.
Maximum Allowed: 500 words. Currently Used: 0 words.
IF YOU'RE REQUESTING TICKET DONATION, DETAIL HOW MANY TICKETS YOU NEED.
Maximum Allowed: 500 words. Currently Used: 0 words.
INFRASTRUCTURE/OPERATING SUPPORT

Please fill out the following information if you're requesting funds for a project that will support the infrastructure or operations of your business or organization.
Please describe the project you are requesting support for. Detail the concept, how it will be implemented and timeline, as well as how it will strengthen your scene or help you become a stronger member of the scene you belong to. *
Maximum Allowed: 1000 words. Currently Used: 0 words.
Budget for Project *
Maximum Allowed: 1000 words. Currently Used: 0 words.

Please indicate a total amount for your project and then include a budget breakdown of how that will be spent.
MIDWESTIX INTEGRATION
Please indicate how you will integrate MIDWESTIX into your event or project. *
Maximum Allowed: 1000 words. Currently Used: 0 words.
Do Not Fill This Out

Wufoo

Support You're Requesting

EVENT SUPPORT

INFRASTRUCTURE/OPERATING SUPPORT

MIDWESTIX INTEGRATION