To help us determine your eligibility and apply for the Complete Meeting Package rate, please fill out the qualification form below.

* = required field
Contact Information
* First Name
* Last Name
* Organization Name
* Email
Preferred Phone
Fax
Address
City
Zip/Postal Code
State
Country
Event Details
Name of Event
Event Type	(select) Conference Meeting Training Board Meeting Retreat Youth Summit Community Event Other
Projected Event Start Date	January February March April May June July August September October November December 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 2008 2009 2010 2011 2012 2013
Alternative Start Date	January February March April May June July August September October November December 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 2008 2009 2010 2011 2012 2013
Number of days of Event
Number of Attendees
Attendee Audience Type   Internal Staff   Non-Profit   Business   Government   Education   Cross-Sector   Other
Number of Overnight Guest Rooms Needed per Night
Number of Meeting Rooms Needed per Day
Meals Needed	(select) Breakfast Breakfast/Lunch Breakfast Lunch and Dinner Lunch Only Dinner Only
Event Services Needed	(select) Audio/Visual Facilitation Speaker Activities Recording Other
Consistency with Institute Mission
Purpose Please provide a concise summary of the purpose of your meeting, event or program.
Issues Please provide a list of issues to be addressed at the event.
Compatibility with mission Describe how your meeting is compatible with the Institute's mission to be a catalyst for action and positive change to ensure the health, sustainability and protection of our environment.
Dissemination of results Describe the expected outcomes of your event and how you plan to disseminate key findings.
Diversity How does your event fit our priority of diverse representation among events, to include a balanced range of topics, sectors, geographic regions and approaches to environmental solutions?
Are you interested in developing new program or event program content with The Institute at the Golden Gate?	(select) Yes No
Are you interested in becoming a partner of The Institute at the Golden Gate?	(select) Yes No Not Sure
Marketing Information
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How did you hear about The Institute at the Golden Gate?	(select) Golden Gate National Parks Conservancy National Park Service Cavallo Point - the Lodge at the Golden Gate Web search Web advertisement Print advertisement Radio Press feature Friend/Colleague Other
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