MEETING REQUEST FORM: Office of the Assistant Secretary Indian Affairs
PLEASE SUBMIT MEETING REQUEST AT LEAST 2 WEEKS IN ADVANCE.
Who are you requesting to meet with: *
Select multiple if your first choice is unavailable
Required
Your Affiliation
Tribe/Organization *
Please enter the Tribe or Organization you represent
Your answer
Tribe/Organization's Mailing Address
Your answer
Are you an official representative for the Tribe/Organization listed above? *
Is your role to meet with others and represent the interests and concerns of the Tribe/Organization listed above?
Is this an officially sanctioned meeting by the Tribe/Organization? *
Is the leadership of the Tribe/Organization aware of and do they approve of this meeting request? If you are representing an interest group separate from the Tribe/Organization, please choose "No".
Your Tribe/Organization's Point of Contact
Name *
Your answer
Email *
Your answer
Office number *
This must be a 10 digit North American formatted number
Your answer
Mobile number *
This must be a 10 digit North American formatted number
Your answer
Your Expected Participants (Name, Title, and email): *
If you have more than one point of contact you may enter their information here. Please include the mobile number of at least one attendee.
Your answer
Meeting Information
Meeting Purpose and Goals: *
Please provide a brief description about the subject and desired outcomes of this meeting. Please limit your response to 500 characters.
Your answer
Meeting Date (earliest) *
Please provide a range of DATES using these boxes below. TIP: Click off of the calendar window after you choose a day to save your selection.
MM
/
DD
/
YYYY
Meeting Date (latest): *
Please provide a range of DATES using these boxes below. TIP: Click off of the calendar window after you choose a day to save your selection.
MM
/
DD
/
YYYY
Preferred Meeting Time *
Please designate the time of day your prefer for your meeting. Will we do our best to accommodate your request, but times can vary depending on availability.
Time
:
Meeting Length and Type: *
How long do you think you need for this meeting?
Special Instructions:
Please limit your response to 250 characters.
Your answer
Submit
Never submit passwords through Google Forms.
This form was created inside of DEPARTMENT OF THE INTERIOR. Report Abuse - Terms of Service - Additional Terms