Program Details Form  
 


To assist Steve in planning his travel, it is imperative that you complete this brief questionnaire and submit it as soon as possible. Each field is extremely important to ensuring Steve arrives on time and understands the agenda. Try not to leave any field blank.

Steve Gilliland
Toll Free: 866-445-5452 / Fax: 336-936-9073
P. O. Box 1600, Mocksville, NC 27028

VENUE
Date of Your Event:
Location:
Start Time:
Room:
A/V Check Time:
Address:
City:
State:
Zip:
Country:
Phone:
Fax:
Program Length:
Audience Size:
Topic:


ON-SITE INFORMATION
Hotel accommodations are to be made by client and directly billed to client whenever possible. A King, Non-Smoking room is Steve's preference. If you would like Steve to make his own reservation, please check the appropriate box. Steve's office will make the reservation.


 Please have Steve make his own reservation
 We will arrange for Steve's hotel


Hotel:
Address:
City:
State:
Zip:
Phone:
Fax:
Check-In:
Check-Out:
Confirmation:


TRANSPORTATION
Transportation to and from airport/hotel/meeting site is to be provided whenever possible. If you would like Steve to rent a car, please check the appropriate box. Steve's office will make the reservation.


Nearest Airport:
Miles from Airport to Venue:
 Please have Steve rent a car
 We will arrange for Steve to be picked up at the airport


Car Service:
Phone Number:
Confirmation:
Pickup Location:


PAYMENT


Accounts Payable Contact:
Phone:
Address:
City:
State:
Zip:
Fax:

 



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   Steve Gilliland
P.O. Box 1600, Mocksville, NC 27028
Phone 866-445-5452 / Fax 336-936-9073  / info@stevegilliland.com

 

Copyright 2011 Steve Gilliland. All Rights Reserved.


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