Application Form

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IAC Beyachad Application Form

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 *

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

Day

Year

• 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:

Math question * 6 + 7 =

Solve this simple math problem and enter the result. E.g. for 1+3, enter 4.

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Which region are you affiliated with?

Date of Birth (optional)

IAC Beyachad

IAC Beyachad Application Form

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