Louie the Lightning Bug
Appearance Request Form
 
* All fields are required.
Contact Information
First Name:  
Last Name:  
Phone: - ex: 314-555-1234
E-Mail Address:  
Energy Service Provider:  
 
Event Information
Name of Event:  
Location:
Street Address:  
City:  
State:  
ZIP Code:  
Event Date:  
Time of Event:  
Expected Attendance:  
Description of Event:
     
Environment: Indoors Bleachers
(select all that apply) Outdoors Auditorium Seating
  Available Lighting Built-in A/V
     
Appropriate Louie Materials:
(select all that apply)		 Louie Character & Ambassador
 
Coloring Books & Activity Books Estimated Quantity
  10' Cold Air Balloon
 
Additional Information (not required)
Comments: