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Rock Form Request
Please submit at least 2 weeks before you would like the form to be live.
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* Indicates required question
Email
*
Your email
Your Name
*
Your answer
What is the name of your form?
Usually your event name.
Your answer
Please provide the exact wording you would like on the form to describe the WHO, WHAT, WHEN, HOW MANY, HOW OFTEN, HOW MUCH. ***Copy and paste the Event Description here if this form is associated with an event.***
*
Your answer
What contact information would you like to collect on this form?
*
Less is more - so don't ask for the info unless it is really needed.
Anonymous (no contact info) - use for anonymous surveys
First & Last Name (recommended)
Email (recommended)
Mobile Phone (recommended)
Home Phone
Work Phone
Mailing Address
Birthday
Gender
Marital Status
Required
This form is associated with an event in Rock?
*
Yes
No
If yes, what is the event date(s)
Your answer
Who gets notified when form is filled out? - optional
name and email
Your answer
What is the cut-off date for registrations?
Please specify your preferred date. The form will automatically "turn off" at midnight of this date. Most forms need to have an end date. If not specified, we will enter an end date of the date of your event - or the last day of your event if it is recurring.
MM
/
DD
/
YYYY
My event has a maximum number who can attend.
*
Yes
No
If yes, how many?
Your answer
I need to collect money.
*
Yes
No
If yes, how much is your event?
Your answer
What account code does the income go to?
Your answer
Do you have an early bird price(s)?
*
Yes
No
If so, what are the prices and cut-off dates?
Admin will monitor and update on the forms and web. Please select business days as the start of a new pricing.
Your answer
My event costs a lot (more than $100), and I would like payment options.
*
Usually we ask for a deposit or the full payment on the registration form and then provide a separate form for participants to make payments. The event coordinator will be responsible for combining the information from the two forms. Reports can be requested from the Finance department as well.
Yes
No
If yes, what is the deposit amount?
Your answer
I need a discount code(s)
Specify what you want your code(s) to be and the % or $ amount off the total. Examples would be a discount for your leadership and/or full and partial scholarships. Examples: LEADER20 = $20 off, WBS100 = 100% off, etc.
Your answer
Would you like a custom confirmation message after the form is submitted? Please type message below.
Your answer
Name(s) of the form manager(s)
*
Who needs access to the admin side of the form and the data?
Your answer
Other options for the form:
Donation Amount (registrant chooses an amount that is applied to a certain account code(s))
File Download (registrant downloads a file you provide)
File Upload (registrant uploads a requested file)
Prioritize (rank items in order of priority)
Scale (rate items on a scale of 1-5)
Other details for the form...
Specify any information to help clarify your needs for the form. Example: Donations to what account? Links to other websites, waivers, prerequisites, materials to be purchased elsewhere, etc.
Your answer
Forward additional information to
info@centerpointmurrieta.com
. For example, the form that you want them to download, etc.
A copy of your responses will be emailed to the address you provided.
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