Contact Information & Form

Corporate Office:

Corporate Event Interactive, Inc.
400 E. Randolph Street, Suite 3725
Chicago, IL 60601
Phone: 312-540-1000
Fax: 312-540-9900
info@corpevent.com

Your Contact Information

*First Name: Please type your first name.

*Last Name: Please type your last name.

Company:

Position:

Street Address:

City:

State/Province:

Zip/Postal:

Country:

*Phone: You must provide a phone number.

Cell:

Extension:

Fax:

*Email: A valid email address is required.Invalid format.

Event Request:

Date(s) of Event:

Time of Event(s):

Number of Participants:

Location/Venue:

Event Room:

Budget (If known):

Length of Time Available For Setup:

Participant Makeup:

Client/Event Website:


What are the primary goals of your event/program?


What would you like CEI to provide for your event/program?


What has your group done in the past for this event/program?


What is the make-up (age, position in the organization, energy level, etc.) of your group?

Additional info about your event/program:

Where did you hear about CEI?

Current CEI client

Email Communication:

Found Website Through:

Referred By:

Other: