Please complete this questionnaire. For a preliminary quote, please complete the items. If your event is confirmed, please complete all items.

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1 Please cmplete this questinnaire. Fr a preliminary qute, please cmplete the items. If yur event is cnfirmed, please cmplete all items. Event Details 1. Event Title: 2. Event Planner Infrmatin: Name: Phne: 3. Pint f Cntact if different than Planner: Name: Phne: 4. Event Lcatin: (please prvide full address including campus name/htel name) Lcatin Name: Lcatin Address: Lcatin City: Phne: 5. Start Date: 6. End Date: 7. Start Time: 8. End Time: 9. Date t Open Registratin: 10. Date t Clse Registratin: 11. Spnsring Organizatin: 12. Spnsring Organizatin URL: 13. Ttal # f Peple Expected: 14. Maximum Capacity: 1 P a g e

2 15. Dress Cde: 16. If event fills, wuld yu like t maintain a Wait List? YES NO 17. Event Website URL: Registratin Fees & Cancellatin Plicy As a member rganizatin, the CPD prvides its members with discunted pricing fr its cnferences and events. In additin, CPD Pints are ffered as a payment ptin. In supprt f thse benefits, the CPD wishes t prvide the same benefits thrugh its Cnference & Event Services. Please cnsider a pricing structure fr yur event that includes discunted pricing fr SUNY CPD Member campuses. Please prvide the fees fr yur event: 18. Registratin Fees (full cnference, ne day, guest, wrkshps, etc.): Full Day Price (CPD member, CUNY, SUNY, Other/Nn-SUNY): One Day Price (CPD member, CUNY, SUNY, Other/Nn-SUNY): Special Discunts (presenters, speakers, hst campus, etc.): Early Registratin Fees (prvide start and end date): Additinal Details 2 P a g e

3 Late Registratin Fees(prvide start and end date): Additinal Details 19. Payment Types Available: CPD Pints Credit Cards (Visa and MasterCard Only) Jurnal Transfers Purchase Orders / Campus Checks Persnal Check 20. Wh shuld checks be made payable t? 21. Where shuld registrants send payments? 22. Vendr Registratin Fees: (if applicable) 23. Optinal Items: ie: purchase a bk; additinal vendr table Cancellatins can be accepted nline. What is yur cancellatin plicy? (last date t cancel, refunds, cancellatin fees, etc) 24. Last day t cancel? 25. Will refunds be issues? YES NO If yes, amunt? (full, ½ etc.) Last day t cancel with refund? 26. Cancellatin Fee: $ 3 P a g e

4 Registratin Optins Please prvide any selectins registrants will need t make during the registratin prcess? Wrkshps/Sessins (title f wrkshp/sessin) Additinal Details Meals (meals r receptin, etc.) Additinal Details Other (briefly describe) Guest Registratin Guest Registratin: A registrant adds a guest (nn-registrant). 27. Will Guest registratin be needed? YES NO 28. What are the Guest registratin ptins and fees (Reg fee, meals, activity)? Optin Fee 4 P a g e

5 Mdificatins Depending n the registratin selectins, a registrant may want t make changes t their registratin. If yu want t allw mdificatins nline: 29. What is the last date fr mdificatins? 30. Hw des a persn mdify their registratin after that date? Persnal/Cntact Infrmatin 31. What infrmatin wuld yu like t gather abut the registrant name, campus/cmpany, , phne? 32. What infrmatin wuld yu like t gather abut their Guests? 33. Pre-event questins can be asked during registratin. Typical questins include ADA Accessibility needs and Meal/Fd restrictins. What additinal questins wuld yu like t ask during registratin? Payment & Invicing CPD accepts CPD Pints, VISA and MasterCard credit card payments. The registrant will be prvided with an nline Cnfirmatin/Invice which they can access nline at any time. The ptin t print and the Cnfirmatin/Invice is als available. N fllw-up fr payment will be dne by the CPD. 5 P a g e

6 Registrant s The fllwing s will be prvided. All s can be custmized t yur needs. Registratin Cnfirmatin aut generated when registratin is submitted Event Reminder can be sent n a date designated by yu Mdificatin Cnfirmatin - aut generated if smene mdifies their registratin Cancellatin Cnfirmatin - aut generated if smene cancels their registratin Payment Cnfirmatin aut generated if smene makes an nline payment 34. Wuld yu like any ther s sent t registrants, guests, speakers, presenters? YES NO Reprting All reprts will be prvided via a secure web page. A link will be prvided fr yu t access the reprts nline, in real time. The ptin t print the reprts r dwnlad the data t Excel r ther frmats will be available. Web Presence The CPD can prvide a bigger web presence fr the event by prviding a micrsite which will include an event verview page, fee page, and up t tw (2) additinal pages (speaker, nline agenda etc.) as determined by yu. The basic site can be custmized with yur event s branding (lg/header and clrs). Please prvide lg/header and event clrs, if applicable. Maximum header width is 926 pixels. 35. Wuld yu like t use the registratin site as yur event website? YES NO If Yes what ther infrmatin wuld yu prvide? 6 P a g e

7 Additinal Details Advertising 36. Wuld yu like the CPD t advertise via the CPD listservs and n the CPD calendar? YES NO Name Badges, Registratin Lists 37. Wuld yu like the CPD t create name badges and/r registratin lists r sign-in sheets fr yur event? YES NO Pst Event Survey/Evaluatin CPD s Survey Tl is integrated with the registratin system. The CPD can prvide yur event survey/evaluatin nline at the end f yur event. invitatins culd be sent t the event participants; and reprts wuld be prvided t yu n the secure reprt web page referred t abve. 38. Wuld yu like t use the CPD Survey/Evaluatin services? YES NO If there any ther infrmatin yu wuld like t prvide, please add it here. If yu have any questins, please feel free t cntact us at r cpdinf@suny.edu. 7 P a g e

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