Schedule Requests Form - DC

Note: Fields marked with an * are required.

Request Type *

Meeting

Event/Speaking

Event Information

Senator's Role at the Event

Event and Background Information

Would you consider a member of the staff if the Senator is not available?

Yes

No

Would you like a greeting letter if the Senator is unable to attend?

Yes

No

Targeted Audience

Expected Attendance?

Dignitaries or Speakers Invited

Dignitaries or Speakers Confirmed

Meeting Information

Purpose for Meeting *

Please provide the specific issues you wish to discuss, including any bills or legislation.
500 Character limit

Names and Titles of Participants *

Request Information

Name of Group/Organization *

Description of Group/Organization *

500 character limit

Contact Information

Prefix *

First Name Of Person Organizing Meeting/Event *

Last Name *

Address 1 *

Address 2

City *

State * ----Military---- AA AE AP ----States---- Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming

Zip Code *

Phone *

Contact Number on the Day of Your Meeting (mobile) *

Email *

Scheduling Information

Available Date(s) of Meeting/Event *

Please provide the specific dates as open ended requests may not be considered. Dates must be in the format yyyy/mm/dd and comma separated. (ex. 2010/01/10,2010/01/11)

Start Time of Event or Availability for a Meeting *

End Time of Event

Event Location *

Event Address 1 *

Event Address 2

Event City *

Event State * ----Military---- AA AE AP ----States---- Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming

Event Zip Code *

Is this event open to the Press? *

Yes

No

Any Additional Information

500 character limit