Wufoo

Organization and Contact Information
Organization Name:
Address
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Phone Number ### - ### - ####
Contact Information
Name: First Last
Position:
Phone Number: ### - ### - ####
Email:
Venue Information
Venue Name:
Address
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Ticket Types: (Check All That Apply)
General Admission Reserved Seating
No. of GA Tickets:
No. of Reserved Tickets:
Americans With Disabilities (ADA) Seating Info (new regulations effective March 2011):
Additional Information:
Event Information
Event Name:
Type of Event:
Event Date(s):
Start Time HH : MM : SS AM/PM
End Time HH : MM : SS AM/PM
Event Image:

Please attach a 300 x300 pixels @ 72 dpi (jpeg)
Event Short Description:
Maximum Allowed: 100 words. Currently Used: 0 words.

Provide description to be used on the website "Info" page (100 word max.)
Event Long Description:

Optional: Provide a description to be used on the website "More Info" page (no limit)
Standard Services Included in Ticket Fee
Web Sales Walk in Sales as MNT Staff Available MNT Style Sheet: Donations (501c3 organizations only - complete donation info below
Services Available at Extra Cost
Mimic Style Sheet (not available for basic event set up) Full Customized Style Sheet (not available for basic event set up) MNM Merchant Account (3.5% of credit card charges + any chargeback fees (MNM cost) Organization's Merchant Account (not available for basic event set up) MNM 800# Box Office (additional monthly fee)
Age or Other Restrictions
Additional Information
Ticket Fulfillment

Please provide the number of each ticket in the fields below.
Printed at Home Tickets
Printed Tickets
Will Call Tickets
Will Call List
Ticket Sales

Please provide the number of ticket sales in the fields below.
Box Office
Online
Pre-Printed (In-Hand)
Ticket/Registration Pricing

Please provide the type and price of each ticket.
Type
Amount $ Dollars . Cents
Type
Amount $ Dollars . Cents
Type
Amount $ Dollars . Cents
MNT Mail Delivery Option ($2.50 fee per order)
Ticket Sales Begin MM / DD / YYYY
Online Sales End MM / DD / YYYY
Phone Sales End MM / DD / YYYY
Refund/Exchange Policy
Ticket Verbiage (30 characters per line maximum).

Venue, Date, Time, Ticket Type are automatically added to your ticket.
Line 1 - e.g., Organization Name
Line 2 - e.g., Presents
Line 3 - Name of Event
Line 4 - e.g., sponsors/other
Line 5 - e.g., sponsors/other
Will Call Information
Additional Information
Donation Information

Nonprofit Organizations Only
Donation Name
Donation Image

Attach a 300 x 300 pixel image @ 72 dpi (jpeg)
Donation Description
Maximum Allowed: 120 words. Currently Used: 0 words.

Attach a description for donation - approx. 100 words
Amount $ Dollars . Cents
Amount $ Dollars . Cents
Amount $ Dollars . Cents
Amount $ Dollars . Cents
Blank Amount $ Dollars . Cents
Additional Information
Reporting Information

Set up user name, password and permissions. User name, password and instructions will be sent once processed.
Name of Person Who Will Run Reports First Last
Email
Accounting:
Event Invoice Event Audit
Event:
Inventory Summary Event Manifest Event Manifest Lite Event Manifest Extract Will Call List
Donations:
Donation Manifest Donation Manifest Extract
Others:
Financial Information

If using MNM's merchant account, payment will be made by check within 7 business days after the event if ALL requested information has been received. For events that run multiple dates, the payments schedule will be based on the event schedule and the agreement between MNM and your organization.
Check Payable To (Disbursements)
Attention
Position
Address to Mail Payment
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Phone Number ### - ### - ####
Tax Identification Number of the Organization (EIN or SSN)
Attach Form W-9
Is your organization tax exempt? If yes, attach IRS 501(c)(3) Letter)
Optional Marketing

ArtsPulse monthly newsletter - $25 per listing (sent by the last day of the prior month)
MyNorthAlert - $50 per message (first-come, first-served, based on availability)

Distribution list approximately 13,500.
Select newsletters you want event to appear in:
ArtsPulse MyNorthAlert
Preferred Date(s) for ArtsPulse:
Preferred Date(s) for MyNorthAlert
Additional Set-Up Information
Include information regarding catalog items, gift coupons, memberships, etc., here.
Do Not Fill This Out

Wufoo

Organization and Contact Information

Contact Information

Venue Information

Event Information

Ticket Fulfillment

Ticket Sales

Ticket/Registration Pricing

Ticket Verbiage (30 characters per line maximum).

Donation Information

Reporting Information

Financial Information

Optional Marketing

Additional Set-Up Information