Indicates required field Your InformationFirst Name: Last Name: Requestor Cell Number:Requestor Office Number:Email:Event DetailsEvent Name:Event Host/Organization:Group’s Twitter Handle:Event Hashtag:Has a date been set for this event?- None -Yes, a date has been set.No, a date has not been set or the date is flexible.Date of Event:MonthMMJanFebMarAprMayJuneJulyAugSepOctNovDecDayDD01020304050607080910111213141516171819202122232425262728293031YearEvent Location:Length Member's Attendance:Would you like the Member to speak?- None -YesNoEvent TopicEvent Description/Purpose of Member's attendance:Please list other speakers and their topics, as well as speaking order:Have / Will you invite members of the media to attend?- None -YesNoWill a photographer be present at the event?- None -YesNoAttire:Attire:- None -CasualBusinessCocktailBlack TieOther…Enter other…Expected Audience Size:Willing to have staff attend event if Member is not able to attend?- None -YesNoOther necessary details/notes:I authorize the Member's office to send me updates by email or phone:You may attach a file to this request:One file only.2 MB limit.Allowed types: pdf doc docx. CAPTCHA: enabled to secure this form. If you are having difficulty using Captcha's visual option, please visit the Accessibility page for more assistance.