Event Request Form

This form has been created to expedite the review of your request.

The Mayor hopes to accept as many public appearance requests as possible.
Your completion of this form will assist in planning the Mayor’s schedule as far in advance as possible.

Please provide the following information:

* denotes a required field  
* Date of Event:
* Time Mayor is requested to attend Event:

* Type of Event:
* Name of Sponsoring Organization:
* Mayor's Requested Role:

If Other:
* In the event of a conflict with the Mayor's schedule, would you accept a Representative of the Mayor's Administration to participate on his behalf?

* Your organization's contact person for event (title, mailing address, e-mail address, work phone number), *cell phone number, and fax number). Cell number is necessary in case of emergency or other day of event scenarios.
* Address/Location of event:
* On-site Telephone Number:
* Parking Instructions:
* Who from your organization will greet the Mayor and/or his staff?
* Estimated number of people attending:
(attach guest list if available)
* Elected officials and/or dignitaries (names and titles) confirmed to attend event:
Fax formal agenda to (203) 385-4108, if available.
* Will the Mayor be introduced?

If yes, who will introduce the Mayor?
* List of people on the dais, if applicable:
* Type of dress:

If Other:
* Requested topic of Mayor's speech/remarks:
Requested length of Mayor's speech/remarks: Minutes
If applicable, please fax any pertinent information that may be useful to the Mayor in preparing his speech/remarks to (203) 385-4108.
* Will the press be invited?

* If yes, will your organization/company handle media outreach?
If yes, please detail which media outlets will be contacted.
Please provide any additional information that will be helpful to the Mayor:
Submitted by:  
* Full name:
* Date:
* Email address:
* Cell/Primary Phone Number:
Other Phone:

The Office of the Mayor will respond to this request in writing if he is attending your event.  Until confirmation is received by letter or email, all requests are considered pending and should not be referenced in invitations or announcements printed or otherwise.  Please allow 21 days for processing.

The Mayor is happy to provide proclamations and certificates of recognition for special occasions upon request.  Proclamations and certificates of recognition for special events can be prepared even if the Mayor’s schedule does not permit him to attend the function.  Please refer to the Mayor’s Proclamation/Certificate Request Form and send it in along with this request.