Louie the Lightning Bug Appearance Request Form
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Contact Information
First Name:
Last Name:
Phone:
E-Mail Address:
Energy Service Provider:	Ameren Illinois Rate Zone l Ameren Illinois Rate Zone ll Ameren Illinois Rate Zone lll Ameren Missouri Learn about Rate Zones
Event Information
Name of Event:
Location:
Street Address:
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State:	MO IL
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Event Date:
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Expected Attendance:
Description of Event:
Environment: (select all that apply)	IndoorsBleachers OutdoorsAuditorium Seating Available LightingBuilt-in A/V
Appropriate Louie Materials: (select all that apply)	Louie Character & Ambassador Coloring Books & Activity Books		Estimated Quantity
Additional Information (not required)
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