Home       Contact Information (Required fields labeled in red.) First Name Last Name E-mail Address Company Name Address 1 Address 2 City State/Province AlabamaAlaskaAlbertaArizonaArkansasBritish ColumbiaCaliforniaColoradoConnecticutDelawareFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineManitobaMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew BrunswickNew HampshireNew JerseyNew MexicoNew YorkNewfoundland and LabradorNorth CarolinaNorth DakotaNorthwest TerritoriesNova ScotiaNunavutOhioOklahomaOntarioOregonPennsylvaniaPrince Edward IslandQuebecRhode IslandSaskatchewanSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWashington DCWest VirginiaWisconsinWyomingYukon Zip/Postal Code Country Phone Fax         General Meeting Information Meeting Name Total Attendees NOTE: To Select a date in the below fields just click on the small calendar to the right of the field and click on a date within the pop-up calendar. Arrival Date Alt. Arrival Date Departure Date Alt. Departure Date         Sleeping Room Requirments Please enter the maximum number of each type of room you will need. Before sending the RFP, you will be given the opportunity to adjust the number of each type of room needed for each night. Enter 0 if you need none of a particular type of room.   Single (1 King) Double (2 Queen) Suite Max Number         Meeting Room Needs Do you need a general session meeting room?   Yes    No NOTE: To Select a date in the below fields just click on the small calendar to the right of the field and click on a date within the pop-up calendar. # of People Start Date End Date Setup Type SelectClassroomTheaterChevronRoundsRounds of 8Rounds of 10Rounds of 12BoardroomConferenceAmphitheaterFood StationsU ShapeCocktail RoundsHollow SquareSee CommentsPerimeterFlowExhibitsTrade ShowTable TopCrescent RoundsSchool RoomReceptionBanquet   Click here to view and select different room layouts for the above field. Do you need any breakout rooms?   Yes    No # of Rooms Start Date End Date Avg. # of People Setup Type SelectClassroomTheaterChevronRoundsRounds of 8Rounds of 10Rounds of 12BoardroomConferenceAmphitheaterFood StationsU ShapeCocktail RoundsHollow SquareSee CommentsPerimeterFlowExhibitsTrade ShowTable TopCrescent RoundsSchool RoomReceptionBanquet   Click here to view and select different room layouts for the above field. Describe any special needs for these meeting rooms.     Audio Visual Needs Check any equipment that you will need in the general session room. TV/VCR Microphone Podium Flip Chart Overhead Projector Screen 35mm Slide Projector LCD Projector Video Projector Audio Taping Video Taping Rear Screen Projection High-Speed Internet Access Wireless Internet Access         Check any equipment that you will need in the breakout rooms. Flip Chart Overhead Projector Screen 35mm Slide Projector LCD Projector Video Projector Audio Taping Video Taping High-Speed Internet Access Wireless Internet Access           Food and Beverage Details Check all F&B functions that may apply. Breakfast AM Coffee Break Lunch PM Coffee Break Dinner Reception       Is there any other information you'd like to provide about your F&B functions?       Additional Comments Comments?   Are there any budget constraints?   Are there other facilities that you are considering for this conference?   What is the timeline for your site selection?

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4751 Lindle Road, Harrisburg PA 17111 Reservations 1.800.637.4817 Telephone 717.939.7841 Guest Facsimile 717.939.9317 Sales Facsimile 717.939.5640

This hotel is independently owned by Hospitality Associates of Harrisburg, L.P and operated by Milestone Hospitality International.