Contracting Organization's Contact Information

Email Address            : 

Company Name             : 
Contact Name             : 
Address                  : 
City                     : 
State                    : 
Zip Code or Postal Code  : 
Country (if not USA)	 : 

Home Phone               : 
Work Phone               : 
Fax Number               : 

Cell Phone               : 

Pager Number             : 

Best Time to Call        : 

Complete Venue Location and Contact Information for the Event *

*(if different from above)

Company Name             : 
Contact Name             : 

Address                  : 
City                     : 
State                    : 
Zip Code or Postal Code  : 
Country			 : 

Home Phone               : 
Work Phone               : 
Fax Number               : 

Cell Phone               : 

Pager Number             : 

Please Describe the Venue

Venue Type    		 : Night ClubFraternity HouseResort PropertyGymnasiumOther
If other, please explain : 
Expected number of guests: Less than 100101-250251-500501-750751-10001001-15001501-20002001-30003001-40004001-5000Over 5000Over 10,000Over 20,000
Indoor or Outdoor Event  : IndoorOutdoor
Water source within 150' : YesNoNot Sure

Electrical Service within

75'(110v, 15amp minimum)?: YesNoNot Sure

What type of flooring?	 : TileCarpetConcreteGrassOther

If other, please explain : 

How high is the ceiling

in the area that the 

party will be held 	 : 

Any doors, stairways

or hallways less than 

32" minimum door opening?: YesNoNot Sure

If Yes, Please explain   : 

Specifics about the Date and Time of the event

Date of the event?	 : 

(mm/dd/yy)            

What time is the

event to begin ?	 : 

What time is the 

foam to begin 		 : 

How long will services

be required 		 : 

What is the earliest 

BEM, Inc. can begin the

set-up process? 	 :  

Additional comments 	 :