Agriculture Immersion Lab Booking Form

Agriculture Immersion Lab Booking Request

Please note: Requests must be received at least 8 weeks prior to event date.
Event Information
Name of Organizer
(organization, county Farm Bureau, etc.)
My event will provide:

An Educational experience for attendeesA county organized general public educational opportunity, such as a fairOther
Please explain other
Name of Event
County
Event Address (location where Event Lab will be parked)

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Please note: Requests must be received at least 8 weeks prior to event date.
START DATE:*

MonthDayYear
Date
END DATE*

MonthDayYear
Date
Time of Event*

:HourMinutesAM/PM Option
Until
until :HourMinutesAM/PM Option
Busiest Hours (when you would like the lab to be open and staffed)*
An event with Immersion Lab staffing is staffed for a maximum of 8 hrs/day and we want to ensure it's staffed during your event’s busiest times.
Number of attendees anticipated at this event:*
Contact and Invoice Information
Event Contact: *

First NameLast Name
Event Contact E-mail*
Event Contact Phone*

Area CodePhone Number
Agreement Invoice Recipient

First NameLast Name
Name of party to be invoiced (if different from above):
Email for Invoice
example@example.com
Address for Invoice

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Should be Empty:

Agriculture Immersion Lab Booking Request