Event Participation Request

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The Air Force Office of Small Business Programs is always seeking opportunities to communicate with the public about our programs and services. If you would like a representative from our office to participate in an upcoming event, please complete the form provided below and a member of our staff will contact you shortly. All fields marked with * are required to submit this form.

Please note that all requests require a minimum of 30 days advance notice to allow for scheduling arrangements.

All requests will receive prompt attention and our participation will be determined by the information provided below.

Your personal information is protected according to the U.S. Air Force Small Business Privacy & Security Policy available on this site at any time from the navigation bar at the bottom of each page.

Event Name*
Venue Name and Address*
Start Date*	Note: You may only select dates after the default date of 24-June-2013.
Start Time*
End Date*	Note: You may only select dates after the default date of 24-June-2013.
End Time*
Number Attendees*
Event Website
Name(s) of companies or organizations presenting/sponsoring this event. (500 word maximum)*
This event is (please check one):* For-Profit Non-profit
POC Salutation
Point of Contact First Name*
Point of Contact Last Name*
Point of Contact Position Title*
Email Address*
Website
Phone*	() - example: (210) 555-5555
Phone Ext.
Cell Phone	() -
Small Business Focus (Check all that Apply)*
HBCU/MSI HUBZone Mentor-Protégé Veteran Owned Small Business 8(a)	Small Disadvantaged Business Women-Owned Small Business Service Disabled Veteran Indian Incentive Program Small Business - Other
Please describe the purpose or theme of the event and explain its relevance to the Air Force mission and/or the Air Force Small Business programs and goals. (500 word maximum)*
Please indicate the type(s) of Air Force Office of Small Business participation requested * (Note: Some fields may expand to additional required fields.) Keynote speaker Speech length and requested topic. If none, please enter N/A: Breakout session speaker Speech length and requested topic. If none, please enter N/A: Panelist Speech length and other panelists participating. If none, please enter N/A: Exhibitor Please list options for booth size. If none, please enter N/A: Matchmaking Attendee Other Please explain:
List any exhibit or attendance fees for the Air Force Office of Small Business. If none please put N/A *
Please provide a demographic breakdown of attendees from the previous event or cite expected attendees if the event is new. (Check all that apply)* (Note: Some fields may expand to additional required fields.) Government/Military List key agencies/organizations and leadership level of attendees (500 words max). If none, please enter N/A: Industry List key categories/types represented (500 words max). If none, please enter N/A: Small business % of total attendees: Large business % of total attendees: Acquisition/contracting community % of total attendees: Other Please provide details:
Please list any Congressional affiliation to this event including: sponsoring, coordinating or participating in this event. If none, put N/A. (500 word maximum)*
Please list any other leadership, high ranking speakers or participants that you believe we should be aware of that are attending this event. (500 word maximum)
Media Provisions (Check all that Apply) Podium Speakers Projector Other Please provide details:

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