Brown County Indiana Conferences and Retreats
Questionnaire

Contact Information
 
First Name: Last Name:
Company: Title/Position:
Email: Phone #:
Fax:  
General Meeting Information
 
1. Name of Meeting:
2.  Projected Dates (mm/dd/yy) Check In Date:   Check Out Date:
3. Estimated Number of Participants:
Accommodations
 
1.  Accommodation Choices:
(check all room categories that you need to reserve)		 Single (1 person per room)  
Double (2 people per room) 
Suites* 
Other
* Suites are a special category of rooms and usually require pre-authorization or prior approval from a supervisor for assignment.
  If other, specify:
2. Total Number of Rooms Required:
  Double Rooms Required:
(choice of 1 or 2 beds per room will be avail.)
  Single Rooms Required:
(One person each room)
  Suites Required:
(criteria of who is eligible for suites and singles will need to be established)
3. Will your group require any
conference/breakout rooms?
  If yes, specify Dates,
# of Rooms, Capacity:
Welcome Reception
 
1. Will the group require a Welcome Cocktail Reception?
Conference Room
 
1.  Type of seating in meeting rooms:
  If other, specify:
Additional Information

List any additional needs or requirements that have not been addressed above:

Thank You for taking the time to fill out this information.
A meeting planner will be in contact to arrange further details.