Keyword:
Entire Site
This Section
E-News Sign-up
Email Us
Visit Washington D.C.
Help with a Federal Agency
Flag Request
If you would like to schedule a meeting or invite me to an event in your community, you can do so by completing the form below. When your scheduling request is received you will be contacted directly to verify your request and discuss the appropriate arrangements. Due to the high volume of scheduling requests, please allow my Scheduler 5 business days to contact you after submitting your request. ***Please note that all requests are subject to Congressman Diaz-Balart's availability***
First Name:*
Last Name:*
Work Phone:*
Mobile Phone:*
E-mail Address:*
Request that Congressman Diaz-Balart: *
Select OneAttend and/or Speak at EventMeet with me or my organization
If request for meeting: What is the meeting regarding?
Meeting dates available:
In which city do you request that the meeting occur?
Is time flexible?
Select OneYesNo
Who will be attending this meeting (please list names, titles, and organizations represented):
Point of contact on day of meeting:
Point of Contact's phone number (cell preferred):
If request for an event: What is the name of the event?
Description of event:
Date of event:
Time of event (beginning and end time):
Time that Mario should arrive:
Location of event:
Address of event:
City:
State:
Zip Code:
Media attending?
Select OneYesNoUnknown
Number of people expected to attend the event:
Point of Contact on day of event:
Do you want Mario to speak at the event?
Time for Mariol to speak (beginning and end time):
Who will introduce Mario?
List issues to be addressed:
Other issues your group is interested in: