Meeting Request Form

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Please kindly complete the details below as thoroughly as possible to make the scheduling process easier. Thank you

Main Contact Person (First name & Last name): *

Title:

Is this meeting request for a constituent, an organization, or a media house? *

Consituent

Organization

Media House

Please provide your contact email address(es) *

Please provide your Address, City, State, Zip code

Contact Phone number(s): *

Please specify the reason for your meeting request? *

Please provide the names, titles, and email addresses of any others who will be in attendance during the meeting when scheduled. (If none, please type in "none".) *

Please list any specific legislation you wish to discuss.

Would you like to request a virtual(online) or in-person meeting with Representative Ford?
*

Virtual (Online)

In-person

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