MGME/HICKORY GLOBAL PARTNERS CLIENT NOMINATION AND REFERRAL PROGRAM

Please complete the following for more information about how MGME may be of service.

What is your Contact Information?

Full Name *

Company *

Email address *

Phone Number

Anticipated event budget

Please note MGME provides services for corporate events with budgets over $100,000 (excluding airfare and hotel accommodations). Please proceed if your anticipated budget exceed this.

Program and Event Details

Please describe the program/event

What country is the event?

City

US STATES

What Provence or Territory in Canada is your event located in: *

What State or Territory in Australia is your event located in? *

Event Start Date * +

Event End Date * +

If you have any RFP or supporting documentation, please attach here.

Referring Company Information

If you are a 3rd party (or a Hickory member) and are referring the company above please complete the following details.

Are you a Hickory Member? *

Yes

No

What is your agency / CTD Name?

First Name

Last Name

Title

Phone Number

Email Address