Scheduling Request
Please submit scheduling requests one month in advance and allow one week for processing.
* Required
First and Last Name
*
Your answer
Organization/Affiliation
*
Your answer
Phone Number
*
Your answer
Email Address
*
Your answer
Zip Code
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Your answer
I would like to request:
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A Meeting with the Councilman
That the Councilman attend an event
Which communities does this issue effect or which community is your event located in?
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Watts
Harbor Gateway North
Harbor Gateway South
Harbor City
Wilmington
San Pedro
Council District 15
Los Angeles
If you are requesting a meeting, please give a brief description of what you would like to cover during the meeting.
Your answer
If you are requesting a meeting, please give your preferred dates and times for the meeting.
Your answer
If you are requesting a meeting, which office location would you prefer?
San Pedro Office
Watts Office
City Hall Office
Clear selection
If you are requesting that the Councilman attend an event, please include the name of the event.
Your answer
Event Date
MM
/
DD
/
YYYY
Event Start Time
Time
:
AM
PM
Event End Time
Time
:
AM
PM
Event Location
Your answer
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.)
Your answer
Event Website/Link to Flyer
Your answer
Certificate Required?
Yes
No
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