Speaker Request Form for Texas State Representative Eric Johnson
If you would like to invite Representative Eric Johnson to speak at your event, please fill out the form below and someone will contact you within 72 hours regarding your request. If you have any questions, please call Representative Johnson's office at 214-565-5663.
Date of Event *
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Event Start Time *
Time
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Event End Time *
Time
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Contact Person *
Your answer
Position/Title of Contact Person *
Your answer
Work Phone Number of Contact Person
Your answer
Cell Number of Contact Person *
Your answer
Mailing Address
Your answer
Email Address *
Your answer
Event Name *
Your answer
Event Location (include specific information including room/floor) *
Your answer
Day of Parking Arrangements *
Your answer
Group/Person Sponsoring the Event *
Your answer
Website (if applicable)
Your answer
Desired Role of Rep. Johnson at the Event (speech, welcome, panelist) *
Your answer
Rep. Johnson's Desired Arrival Time *
Time
:
Estimated Attendance *
Your answer
Audience Composition (students, women, etc.) *
Your answer
Attire *
Your answer
Topic *
Your answer
Length of Remarks *
Your answer
Location of Delivery (podium, dais) *
Your answer
Can a Power Point presentation be given? *
Your answer
Is there a wall or screen? *
Your answer
Who will introduce Rep. Johnson? *
Your answer
Where will Rep. Johnson be seated and with whom? *
Your answer
Will other elected officials be in attendance? (If yes, please list) *
Your answer
Will other candidates for office be in attendance? (If yes, please list) *
Your answer
Has Rep. Johnson spoken to this group in the past? (If yes, please list when) *
Your answer
Contact Person at Event Location *
Your answer
Cell Number of Contact Person at the Event *
Your answer
Position/Title of Contact Person at the Event *
Your answer
Is staff invited to attend? *
Is Rep. Johnson's wife invited to attend? *
If Rep. Johnson is unavailable, should staff attend? *
Any other details you feel are relevant to include:
Your answer
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