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NIU Outreach Center Request for Information

Tell us a little about yourself...

* Salutation: 

 

* First Name: 

 

* Last Name: 

 

Title: 

 

Department: 

 

Company: 

 

* Address 1: 

 

Address 2: 

 

* City: 

 

* State or Province: 

 

* Zip or Postal Code: 

 

Country: 

 

* Email Address: 

 

* Business Phone: 

 

Fax: 

 

Preferred Contact Method: 

 

Tell us a little about your event...

* Which NIU Outreach Center locations are of interest to you?

 

 

*Hold 'ctrl' when clicking to choose multiple selections.

Event Name: 

 

Type of Event: 

 

Event Description: 

 

Estimated Number of  Attendees: 

 

Event Start Date: 

 

Event End Date: 

 

Alternate Event Start Date: 

 

Alternate Event End Date: 

 

Event Start Time: 

 

Event End Time: 

 

Room Configuration: 

 

AV Needs: 

 

*Hold 'ctrl' when clicking to choose multiple selections.

Additional AV Needs: 

 

Please check any catering requirements you may have:

 

Morning Break

 

Lunch

 

Afternoon Break

 

Dinner

Is there anything else we  should know about your  event? 

 

* How did you hear about us? 

 

*Hold 'ctrl' when clicking to choose multiple selections.

If other, please tell us where   you heard about us. 

Would you like additional information about:

 

Area Hotels

 

Meetings and Event Planning

 

Registration Services

 

 Yes, please sign me up to receive Outreach Centers news updates and promotional emails!

 

 

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Northern Illinois Universityoutreachcenters@niu.edu(866) 753-0010