Meeting & Event Request

Name of Organization/Individual*
Contact Number*
Email*
Event Description/Purpose*
Please provide as much event details as possible along with the purpose of requesting the Supervisor’s attendance
Event Date
MM slash DD slash YYYY
Start Time for Supervisor Presentation

: Hours

Minutes

AM/PM
End Time for Supervisor Presentation

: Hours

Minutes

AM/PM
Location*
Is the location in District 3?*
- Yes
- No
- Not sure
Location Address
Street Address City State ZIP Code
Parking and Check-in Details
Who will receive/introduce Supervisor Horvath?
Please list the formal program schedule and the speakers
Please describe the event set-up and audience
Will photo coverage be provided?
- Yes
- No
- Not sure
If media is invited please list the invitees, otherwise indicate "No Media"
Who are the sponsoring organizations?
If Supervisor Horvath cannot attend, can she send a representative?
- Yes
- No
Any requests for certificates or letters of commendation need to be made at least two weeks in advance.
CAPTCHA