Scheduling Request
Please submit scheduling requests one month in advance and allow one week for processing.
First and Last Name *
Organization/Affiliation *
Phone Number *
Email Address *
Zip Code *
I would like to request: *
Which communities does this issue effect or which community is your event located in? *
If you are requesting a meeting, please give a brief description of what you would like to cover during the meeting.
If you are requesting a meeting, please give your preferred dates and times for the meeting.
If you are requesting a meeting, which office location would you prefer?
Clear selection
If you are requesting that the Councilman attend an event, please include the name of the event.
Event Date
MM
/
DD
/
YYYY
Event Start Time
Time
:
Event End Time
Time
:
Event Location
Event Description
Please describe the event and the role you would like the Councilman to have at the event (for example: give remarks, ribbon cutting, etc.)
Event Website/Link to Flyer
Certificate Required?
Submit
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