Request for PIMS Event Support

Requesting Organization:

Rank / Title:

Requesting Individual: * First and Last Name

Email Address: *

Phone Number: * Country Code, Area Code

Event / Exercise Date: *

Event / Exercise Location:

Event / Exercise Name: *

Event / Exercise - Planning Conferences, Dates, Locations: If PIMS support is required at Initial, Main, or Final Planning Conferences, please describe what capabilities are required

Event / Exercise Purpose, Impact: Objectives of Event / Exercise, Cooperative Topics to be Addressed.

Number of Participants:

Participating Countries, Organizations, Institutions:

Requied Information Sharing Capabilities - Internet-based Solutions: Describe what kind of information sharing, planning assistance is needed.

Required Information Systems - Hardware, Capabilities: Describe the type and quantity of computer and communication systems.

Required Internet Connectivity: Is connectivity available at the event / exercise location? If needed, describe what kind of connectivity the event / exercise requires.