D.C. Event Request

"*" indicates required fields

Organization Making Request*

What connection, if any, does your organization have to the state of Delaware?*

Prefix*

First Name*

Last Name*

Email*

Enter Email Confirm Email

Phone Number*

Alternate Phone Number

Onsite Point of Contact*

Onsite Point of Contact cell phone*

Name of Event*

Type of Event

Event Start Date*

Event End Date*

Event Start Time*

Event End Time*

Media Expected*

Time Senator Requested to Speak (If Requested)

Length of Speech

Event Location

Address

Is parking available? If so, where?

Senator's Role at Event

Podium/Stage Format

Event & Background Information (Please provide a copy of any news release or agenda)

Order of Speakers

Topic of Speech

Expected Number Attending

Delawareans Invited or Confirmed (Please Indicate)

Dignitaries or Speakers Invited or Confirmed (Please Indicate)

Will consider field representative if Senator is unavailable?

Sending Greeting Letter or Video if Senator is unavailable?

Other Comments