Convention Services Form Name:* First Last Contact Address:* Street AddressStreet Address Line 2CityAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict Of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingState / Province / RegionPostal / Zip CodeCompany:E-mail:*Phone:* Area Code - Phone Number Convention InformationFirst Day of the Convention:*Last Day of the Convention:(1)*Convention Location:Type of Location:Convention CenterHotelotherLocation Address:* Street AddressStreet Address Line 2CityAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict Of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingState / Province / RegionPostal / Zip CodeStart Time:* : AMPMHHMMAM/PMEnd Time:* : AMPMHHMMAM/PMIs Location a Union House?*Not UnionUnion HouseAdmission Required:*YesNoYes But CoveredConvention Services Requested:*Balloon AnimalsMurder Mystery ShowFaux CelebrityCasino NightMobile Photo StudiootherSubmitI acknowledge that I am requesting convention entertainment services and that this is NOT a confirmed booking until it is confirmed by the Fargo Entertainment Company.*AcknowledgeSubmitResetSales Person Involved:*Lisa TellinghuisenMikayla FischerRandy LongWord Verification: