PRIME2012 | Hosted Planner Qualification Form

: PRIME2012 Business Exchange, Honolulu, Hawai`i | : Post-Site Excursions

As PRIME2012 is limited to a select group of qualified planners, please insure that we receive the Hosted Planner Qualification Form prior to November 21, 2012.

YES, I would like to attend PRIME2012 as a Hosted Planner. Following is my completed Hosted Planner Qualification Form.		NO, I cannot attend PRIME2012. Please send invitation to:
Name		Name
Organization		Organization
Title		Title
Mailing Address		Mailing Address
City		City
State		State
Zip Code		Zip Code
Main Switchboard		Main Switchboard
Direct Line		Direct Line
E-mail		E-mail
Website
I prefer to be contacted via:	Telephone E-mail	I prefer to be contacted via:	Telephone E-mail
Yes No	Please note whether or not you have participated in a previous PRIME program

Qualification Requirements for all PRIME2012 Applicants
(please review carefully BEFORE applying)

In order to qualify as a Hosted Planner for PRIME2012, applicants must be a representative on one of the following MICE entities.

Association/Non-Profit: Associations/Non-Profit which initiate and run their own stand-alone meetings off-shore including Asia-Pacific and/or Hawai`i.
Corporation: Corporations which initiate and run their own stand-alone meetings and/or incentive travel award programs off-shore including Asia-Pacific and/or Hawai`i and have done so for at least 2 of the past 3 years (bookings will be checked thoroughly by a member of the PRIME2012 Selection Committee).
Incentive Travel House/Event Management Company: Contracted by North American-based clients to search and book venues/destinations and/or organize corporate incentive travel programs off-shore including Asia-Pacific and/or Hawai`i.
- Please provide 2 clients’ company names (if necessary, list as Confidential)
  Confidential Yes No
  Confidential Yes No
Third Party/Independent Meeting Planner: Contracted by North American-based clients to search and book venues/destinations and/or organize corporate incentive travel programs/events off-shore including Asia-Pacific and/or Hawai`i.
- Please provide 2 clients’ company names (if necessary, list as Confidential)
  Confidential Yes No
  Confidential Yes No
- You may bring a client to PRIME2012. If bringing a client, please have your client complete a Hosted Planner Qualification Form prior to the deadline and have them note on the form that they are your client. If your client is unable to attend, please provide a letter from your client advising that you will be using PRIME2012 to site inspect on their behalf for a specific program and/or event.

Identify the 3 most recent off-shore destinations as well as the hotel property, # of attendees, and dates in which your organization booked stand-alone conferences, corporate meetings and/or incentive programs/events from 2010-2012:

	Location	Hotel	# of Attendees	Month/Year (mm/yy)
1)
2)
3)

Please check the destinations, which are under consideration for a future meeting, convention or incentive trip for 2013-2015.

Big Island of Hawai`i	Kaua`i	Lana`i	Maui	O`ahu
Australia	China	Fiji	Hong Kong	Japan
Korea	Macau	Malaysia	New Zealand	Singapore

If the destination you are considering is not listed above, please indicate the destination you are considering for a future meeting, convention or incentive trip?

How many attendees?
Date under consideration (mm/yy) Decision date (mm/yy)

List already booked future events for 2012 and beyond:

	Location	Hotel	# of Attendees	Month/Year (mm/yy)
1)
2)
3)

Please include a full description of your site-selection/negotiation responsibilities in the above events:

How influential are you in the site/venue selection process:

To whom do you report (please include first/last name, title, contact phone number, email):

Please provide a recap(s) of your organization’s meeting, conventions, events, or incentive programs and it’s potential for a PRIME participating destination. Please also include information on the global economic affect on your organization’s present and future meetings & incentives:

How did you hear about PRIME2012?

	PRIME2012 Invitation
	HVCB Referral
	Other: please specify

Applicant Agreement:
By completing this form and applying to be considered as a Hosted Planner for PRIME2012, I declare and warrant that all responses provided herein are entirely truthful. I also understand that before qualification is determined, all information submitted herein will be verified by a member of the PRIME2012 Selection Committee, i.e., PRIME Selection Committee will be contacting third-party applications’ clients whose information will be requested during the interview period — and/or checking with applicants’ supervisors.

I agree to this statement (full name) Date (mm/dd/yy)

If you have any questions, please e-mail prime-aloha@hawaii.rr.com or call (808) 597-1179.

Our Selection Committee will review your application within 5 business days of receipt of the completed Qualification Form. Once approved, you will receive a follow-up confirmation and instructions to complete the Travel Registration process.