NALA Visit Report Please fill out the following form and submit one week from date of visit. Is this an Original or an Amended report? Original Amended Date of Visit Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Day Day12345678910111213141516171819202122232425262728293031 Year Year20152016201720182019 Name (Member attending site visit) NALA Materials Sent Type of Visit/Event Affiliated Association Event Tradeshow Event School or Other Event Information Affiliated Association or Tradeshow Name Name/Title of Event Location City State - None -AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarshall IslandsMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Marianas IslandsOhioOklahomaOregonPalauPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirgin IslandsVirginiaWashingtonWest VirginiaWisconsinWyoming Contact Person Name Phone Number Email Attendance (Actual or estimate) Door Prize Winner's Contact Information Sent to Headquarters? Yes No Door Prize Winner's Name Prize Drawing Slips/Business Cards Given to Headquarters? Yes No Value Added/Positive Take-a-ways for NALA Any Booth or Visit Issues or Concerns? Areas of Improvement - How can we make it better? Follow-up or Pending Items Comments Accident/Incident During your travel on this visit, were you involved in any accident or incident? Yes No Please submit an accident report to the Executive Director. Submit Read more about NALA Visit Report
Article Interest What topic would you like to see in an upcoming Facts & Findings publication? Topic What level would you want the topic to be written? Basic Intermediate Advanced Would you be interesting in writing this article or something different? Yes No If you selected yes, what topics are you interested in writing about? Your Name Email Submit Read more about Article Interest
Know a Great Speaker? If you know a great speaker that we should consider, please let us know. Speaker First Name Speaker Last Name Speaker Email Speaker Phone Number What topics did this speaker present? What organization held the event in which the speaker presented? What month and year did you hear this speaker? Your Name Your Email Submit Read more about Know a Great Speaker?
Affiliate Visit Requests NALA welcomes each of its affiliated associations to submit one (1) visit request each calendar year. We strongly suggest that your visit be requested at least 6 months before your event date. Please note: Submitting this form does not guarantee that a NALA rep will be able to attend your event/meeting. Your request is confirmed when you receive confirmation of the name of the NALA rep who will be able to attend. If a NALA Rep is not available for your visit, it will be communicated directly to the affiliate’s contact person. Affiliate Name * City * State * Contact Person * Email * Phone To view the affiliated associations visitation and expense reimbursement policy please click here. Meeting/Event Name * Meeting/Event Date Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Day Day12345678910111213141516171819202122232425262728293031 Year Year201720182019 Meeting Event Time Hour Hour123456789101112 : Minute Minute0030 am pm In what capacity are you requesting a NALA representative? * Please select all that apply. Speaker NALA Expo Hall / Tradeshow Representative NALA Materials Only (no representative requested) Preferred NALA Representative to Attend? (if any) Please note that based on schedules and other factors your preferred representative may not be assigned. Expected Amount of Attendees at your Event/Meeting? * Location of Meeting (if known) Details of speaking request If you are requesting a NALA representative to speak at your event, please provide us with additional details on the topic requested and the length of the presentation. Submit Read more about Affiliate Visit Requests
