ERA Chapter Event Services Form « Electronics Representatives Association

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ERA Chapter Services Request Form

Your event information will automatically be added to the ERA Industry and Chapter calendar after your approval.

Chapter *

Request submitted by *

Company *

Event Information

* Required fields are indicated with an asterisk.

Event Name *

Event Contact *

Event Contact Email *

Event Contact Telephone

Event Venue *

Venue Address/Telephone

Event Date *

Event Time(s) *

Event Description

Provide as much information about the event as possible. If description is lengthy, feel free to email Word, Excel or PDF files to Erin Collins at ecollins@era.org.

Event Description

Single Checkbox Field

I will submit event info by email

Email Recipients

If you require marketing emails for this event, please indicate who in the ERA database should be included in the list. If you have additional email addresses to add, please email to Erin Collins at ecollins@era.org.

Registration Form Information

If you require online registration or online registration with payment, please provide as much information about the data you want to collect from your attendees, as well as all fees associated with the event.

If you do not require registration, skip this section.

Registration data to be collected:

Fees to be collected:

Additional Information

Please provide any additional information or inquiries about your email campaign/registration below.

Additional Information:

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