Chapter Activities Form

PAS Chapter:

Primary Contact Information

First Name:

Last Name:

Email Address:

Phone Number:

Shipping Contact Information

Shipping Contact:

Same as Primary ContactDifferent Shipping Contact

First Name:

Last Name:

Email Address:

Phone Number:

First Name:

Last Name:

Email Address:

Phone Number:

Shipping Information

Address

City

Country

State/Province

State

Provinces

ZIP/Postal Code

General Event Information

What type of event are you hosting?

Clinic(s)Percussion Workshop/FestivalOther

If other, please define the type of event:

Does your chapter have a PAS banner?

YesNo

Event Details

Event Name:

Event Location:

Start Date:

Estimated Attendance:

1-5050+

Additional notes or instructions:

Please upload any promotional flyer(s) that you would like to share:

Please upload a detailed event budget:

Contact Information