After you submit your elected official scheduling request, you will receive an automatic e-mail confirming receipt of the request. Please note that completing this form does not guarantee the Mayor or Councilmember's participation or attendance at your event. The City Clerk's Office will respond to all requests within 5 business days. Please submit requests at least 2 weeks prior to your event.

Name of Event: *

Event Date: *

Name of Requested Attendees:

Mayor Robert Croslin Council President Joseph Solomon, Ward 5 Council Vice President Danny Schaible, Ward 2 Councilmember Sam Denes, Ward 1 Councilmember Joanne Waszczak, Ward 1 Councilmember Emily Strab, Ward 2

Councilmember Ben Simasek, Ward 3 Councilmember Jimmy McClellan, Ward 3 Councilmember Edouard Haba, Ward 4 Councilmember Daniel Peabody, Ward 4 Councilmember Rommel A. Sandino Ward 5

Event Type:*

Award Ceremony Community Meeting Conference Discussion Panel/Group Groundbreaking Meeting Ribbon Cutting Reception Walkthrough/Tour Other (Please note in comments)

Event Time (Start/Finish):*

Event Location: *

Event Location Is:

Indoor Outdoor Development Site

Approximate Number of Attendees:

Is the Event Open to the Public?

Yes

No

Press Information:

Press Invited Closed to Press

Not Sure

Are you requesting the official to speak?

Yes

No

Type of Remarks:*

No Remarks Necessary Opening Remarks Brief Remarks Keynote Speech Closing Remarks Panel Discussion Q&A

Duration of Remarks:*

N/A 1-3 Minutes 5-7 Minutes 8+ Minutes

Event Description:

Contact Information (Name & Title)*

Organization Name:

Contact Phone:

Contact Email: