IMPACT23 December Regional Event Prospectus

IMPACT24 Regional Event Application - September

Thank you for your interest in hosting an IMPACT24 September regional event on September 18, 2024. Forms will be approved on a rolling basis in a first come, first served order and no later than JULY XX, 2024. The latest date to submit a form is JULY XX, 2024. No more than one regional event will be approved per 200 mile radius.

Please review the regional event hosting requirements before filling out the form to confirm your company is able to meet them.

Contact Information

Your company*

Your name*

E-mail Address*

Phone Number

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Regional Event Host Company

Company Name*

Please list any other companies that will be hosting with you:*

Would you be interested in hosting with another company if you're not already (another company on the Affiliates Council, NAEM corporate member or both)?

Yes, Corporate Member Only

Yes, Affiliates Council Member Only

Both

Location, City, Date & Time of Regional Event & Networking Event

Location City*

Proposed Date of Regional Event (We recommend December 7 so it coincides with our Impact event but are open to another date in September 2024)

Proposed Start and End Time of Regional Event

New code

Please type the code above

Other Logistical Details

If you’re approved to host a networking event, we will require that you provide a schedule for the event by DATE. You’ll have the option to play one or both of the sessions from the IMPACT24 September agenda at your event. You’ll also have the option to lead one or both of the breakout sessions on the IMPACT24 September agenda at your event. Please email any questions to sales@naem.org.

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