Event Registration Request Renown Health

Submitter's Information

Name*

First Last

Are you a Renown Health employee?*

Yes
No

Job Title*

Email Address*

Phone Number*

Organization/Department*

Please provide the name of your organization? If you are a Renown Health employee, please provide your department name.

Event Information

Do you need to add or edit an event?*

Add an event
Edit an existing event

Is this an internal event for Renown employees or an external event for the public to attend?*

Internal, Renown Employees only
External, Public welcome

What type of event is this?*

Non-Profit/Community Education (Public Event)
Medical/Pharmaceutical (Staff Only)
Private Space Rental (Closed to Public)

What is the link (or URL) of your event?

Please describe the edits you need made to your event.

Event Name*

Event Facilitator's Name*

First Last

Event Facilitator's Title

Leave blank if it is the same as the Submitter's information provided above.

Event Facilitator's Email

Leave blank if it is the same as the Submitter.

Event Facilitator's Phone Number*

Leave blank if it is the same as the Submitter's information provided above.

Is this a recurring event?*

Yes
No

If so, please detail the dates and times that this meeting will need to be held.*

Event Start Date*

Requested Start Time*

: HH

MM

Requested Start Time

Event End Date*

Requested End Time*

: HH

MM

Requested End Time

Is this a paid event?*

Yes
No

What is the Price per ticket?*

What is the Cost Conter ID?*

This Cost Center / Department will be the one receiving payment.

What is the name of the Cost Center's Department?*

This Cost Center / Department will be the one receiving payment.

Will participants need to register for this event?*

Yes
No

Are there seat limits for this event?*

Yes
No

If yes, how many?*

Number of Attendees*

Venue Name

Venue Address

Street Address Address Line 2 City State ZIP Code

Tell us about your event.*

Please Upload Relevant Files

Drop files here or

This could be a word doc, or photos you want to include for your event.

How would you like the room to be set up?*

Will you be requesting food to be served at this event?*

Yes
No

Will this event need any of the following:*

Audio
Video
Teleconference
All the above
None of the above

Event Registration Request

Submitter's Information

Event Information

How is Book Ahead Calculated?