Appointment Request for Representative Lana Theis
Thank you for your interest in meeting with Representative Lana Theis. Please fill out the information below and the Representative scheduler will follow up with your request. (Please note that submitting a request does not constitute as a meeting commitment; and all requests are subject to review and approval by the Representative's scheduler.)

Michigan law prohibits the use of state resources or tax payer funds to be used for campaign purposes. Please know that this form cannot be used to request the Representative to attend any type of campaign related events.

If you have any questions regarding your request, please contact the Office of State Representative Lana Theis at (517) 373-1784 or at LanaTheis@house.mi.gov.

Name *
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Organization
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E-Mail *
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Phone Number *
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Purpose of the Meeting *
If your request is regarding legislation, please list the topic and/or bill numbers:
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Date of Event/Appointment *
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Preferred Time of Event/Appointment
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Notes or Additional Information
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