Organization representatives Name:

Representatives Email Address:

Name of Organization

Please give an information contact phone number:

Organization's official contact email address (if none leave blank)

Organizations Web Site Address (URL) (example: www.somewhere.com)

Please briefly describe the upcoming meeting: (Purpose)

Please list the date(s) of your meeting(s):
(Note: if your meetings are re-occuring on a set day of the month like the
2nd Thursday, then no dates are need. Simply enter the re-occuring day(s))

Please list the times of your meetings:

Location of your meeting(s):  (please give exact street address)

Directions to meeting(s) for those not familiar with the area or location:

Please enter a 2 to 3 sentence description of your organization

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