Retirement/Farewell Reception Event Request Form

Client Information

*Who is this reception for?
Honoree's First Name: Honoree's Last Name

*Years of Employment:

*Current Title:

*Department or Office:

Lead Contact for the Reception

* Contact Name:
Contact's First Name: Contact's Last Name:

*Phone Number:

*Email Address:

Event Information

*Date:

*Time:
 12-hour Display: AM PM

*Location:

STOP! You cannot submit this form until the location has been confirmed with Mark Hendrix (mhendrix@gregorybgallagher.com or 660.562.1420).

*Number of Guests Expected:

Refreshments

These are only suggestions based on cost per person for a reception for 75-100 people. Indicate your choices or make requests and the event coordinator will work with the caterer's to stay under the $400 budgeted amount.

Other Request:

Music Playlist

Make specific song, genre or artist requests:

Decoration Requests

Make decoration requests: (theme, balloons, color, etc.)