WCLC 2018 - Advisory Board & Ancillary Meetings

ANCILLARY EVENT REQUEST FORM

Please complete all sections of the following Ancillary Event Request Form. 
If you require multiple events, please complete one form for each function you would like to hold. 
1) Contact Information *
Company Name
Third Party Organizer (i.e. Medical Communication Firm)
Contact Person
Address
City/State
Postal Code
Country
Phone Number
Email
2) Event Information

Type of Meeting 
*

Time & Date of Meeting 
*
Meeting Title
Start Date *
End Date *
*
Preferred Start Time
Preferred End Time
Expected Attendance
Location (Intercontinental Hotel, offsite, etc.)
Room Set-up *