Scheduling Request - Meeting/Event Form

Request Information
Date of Request:
Requestor Name/Title: *
Organization Name:
Organization Address:
Phone (xxx-xxx-xxxx): *
Email (Preferred):
Meeting/Event Details
Date of Meeting Request/Event: *
Time of Meeting/Event: *
(If event, provide exact time Mayor should arrive) Time Format:(01:45am)

Mayor Time:
Location of Meeting/Event: *
(Provide exact address; including suite and/or room number)
Meeting/Event Purpose: *
(Please be specific)
Other speakers or invited guests:
(Will there be any other elected officials/dignitaries)
If this is an event, will a speech or greetings be required (Y/N)?: *
Topic of speech: *
Length of speech: *
Is event open to media?
(Specify: print, radio, TV with contact information, including cell phone and email address):

Additional Information
Event format:



Description of Audience: * (including total number of attendees expected)
Seating (Head Table/Dais)