PermalinkPosted: Nov 28, 2015 by admin Tags: Please complete the IAC Beyachad Application Form below. If you have questions please contact [email protected] First Name: * Last Name: * Email Address: * Phone Number: * City * State * - Select -AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingDistrict of ColumbiaAmerican SamoaGuamNorthern Mariana IslandsPuerto RicoUnited States Minor Outlying IslandsVirgin Islands, U.S.Other-Canada ZipCode * Are you affiliated with a non-profit organization? If so, please include name and position. Name of the event you would like to host * Date of event: Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Day Day12345678910111213141516171819202122232425262728293031 Year Year202420252026 • Note: we will need at least one month’s notice. Program Description Who is your target audience? * Age, interests, language, etc Please provide a detailed explanation on how your program or event will demonstrate continued engagement with the IAC programs. * Venue of the event * How many participants do you anticipate for the event? * Will alcohol be served at the event? If so, does the venue hold an alcohol license? * Does the event include serving any kind of food and/or refreshments?* * *Every event that includes serving any type of food should state he following sentence on the invitations/brochures : “Please make sure to check the food ingredients in order to avoid any food allergy reaction, you know best what is good for you!” Total budget of the event * Amount requested from the IAC * Expenses (please describe) * Price per Ticket * Are there local partners for this event? If yes, which? * If you wish to include any further notes or details: