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Request for Mayor / City Council Member at a Special Event

2. Please Note

   Completion of this form does not confirm the attendance of the Mayor or any Member of City Council at your event.

   Once your invitation has been received, you will be contacted as soon as possible.

4. Point of Contact

   Sandy Madison
   Phone: 757-382-6151
   Email Sandy Madison

6. Name of Event*
7. Date*
   Date
8. Start and End Time*
   Start and End Time Start Time

   —

   Start and End Time End Time
10. Place/Address of Event*
12. Hosting Organization or Group*
14. Point of Contact Name*
15. Point of Contact Email Address
16. Point of Contact Cell Phone Number*
18. Name of Requested Public Official*
19. Approximate Number of Attendees*
20. Welcome Address?*

    1. Yes
    2. No
22. Keynote Address?

    1. Yes
    2. No
23. Length of Time for Remarks, if Applicable
24. Start Time for Remarks, if Applicable
    Start Time for Remarks, if Applicable
25. Required Arrival Time for Mayor/Council Members*
    Required Arrival Time for Mayor/Council Members
27. Point of Contact Name and Cell Number at the Event, if Different from Above
28. Name(s) of Leadership of Organization who will be in Attendance
30. Any Additional Information, including History of the Organization or Group.
Leave This Blank:


32. 1. Receive an email copy of this form.
33. Email address

    This field is not part of the form submission.

34. Submit

* indicates a required field