MIXER HOST REQUEST FORM

Months your company is available to host a mixer: (Check all that apply) *

January February March April May June July August September November December

Mixer will be held: *

Outdoors Indoors

Host will provide: (Check all that apply) *

Food and non-alcoholic beverages for attendees (*) Prize for raffle tickets (*) Prize for business card drawing (*) Area to set up bar (*) 3 to 5 tables for new members Sound system Beer and/or Wine Volunteers to staff mixer

Items with (*) are mandatory.

INFORMATION ABOUT YOUR ORGANIZATION

Organization name: *

How many people can your location accommodate? *

Address Block - US

Enter the address where you would host the mixer.

Address Line 1 *

Address Line 2

City *

Zip/Postal Code *

Organization's Anniversary month

Format: M/d/yyyy

CONTACT INFORMATION:

Enter the name of the person responsible for coordinating the mixer.

First Name *

Last Name *

Best time and method to contact you: *

Phone number *

Email: *

Your organization is a:

Current member Current sponsor Willing to become a member/sponsor

Applying does not guarantee approval. Approvals are made through the Solano Hispanic Chamber Board of Directors. Thank you for volunteering to host a mixer.

MIXER HOST REQUEST FORM

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Solano Hispanic Chamber of Commerce