Chapter Support Request Form - Connect Worldwide

Chapter Support Request Form

First Name *		Last Name *
Email Address *		Phone *
Address Line 1		Address Line 2
City		State/Province
Zip/Postal Code		Country *
Chapter *		Is your chapter affilated? *
Type of support request: *
Event date: *Format:mmddyyy		Event location: *
Number of attendees(estimated total)
Technical focus for the event(check all that apply)	HP NonStop HP-UX Linux OpenVMS Storage Windows Software Other	Number of chapter members?(estimated amount)
Number of HP employees?(estimated amount)		Number of partners/vendors?(estimated amount)
Topic/Meeting Agenda:
Amount of money requesting		Amount chapter is contributing
How with the funding be used?
Is your HP Liason supporting?	yes no	Suppot type & name (HP Liason)
Working with an HP partner?	yes no	Partner type and name
Membership fees charged?(by the chapter)	yes no	If yes, specify amount
Event revenue & net profit(expected gain)
Additional Details of Request: