Requests for the Mayor or City Council's attendance to an event should be made in writing to the City Secretary’s Office at least 10 working days in advance.

Requestor's Name:*

Requestor's Address:*

City:*

State:*

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Zip:*

Email:*

Phone Number (must contain no decimal places or dashes):*

List the name of the Mayor or City Council representative(s) you wish to be in attendance: *

Mayor, City Councilmembers, Positions, and Term Expirations

List of Mayor & City Councilmembers

Title of event & brief explanation:*

Date of Event:*

Time of Event:*

What time is the Mayor/Councilmember expected to arrive? Period of time you expect the Mayor/Councilmember to be in attendance.

Where is the Mayor/Councilmember specifically expected to be (Name and address of facility including room number/name/city)

Who is the contact person? Please provide their office number and/or cell number.

What will the Mayor/Councilmember's function be at this event?

Will the Mayor/Councilmember be expected to speak?*

Yes

No

If so, on what topic and for how long? Are you requesting a speech or informal remarks? Will there be other speakers at this event? If so, please provide names & titles.

Will audio/visual equipment be available for Mayor/City Councilmember’s presentation, i.e., computer, screen, projector, etc.?

Will pictures be taken of the Mayor/City Councilmember? If so, describe type of pictures.

Who is going to be in attendance and how many people are expected?

What type of attire is appropriate for this function?

Are spouses invited?

Yes

No

Please attach a proposed agenda/program for this event. All invitations, correspondence, and flyers using Mayor/City Councilmember’s name must be approved before your organization can print or disseminate the information.

Date of request (must be at least 10 working days in advance of when it is needed.) (format mm/dd/yyyy)*

Signature of Requestor:*