Event Request

Please fill out the below form with all the details for the event.

If you have any questions, please email my Legislative Aide William.Woodring@mahouse.gov

Name of Organization

Event Title

Ex: MIRA's 57th Annual Gala

Point Person

First Name

Last Name

Phone

(###)

###

####

Time

Hour

Minute

Second

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Parking Information

Speaking Request?

Yes

If yes, what time, for how long and on what topic?

What is the intended audience?

Are any elected officials invited?

Please insert Agenda

Do you need a citation?