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Request Presence of Your Elected Official
Page Content
Please use this form to request the presence of your Elected Official at an event.
Submitted By
*
Select an Elected Official
Which Elected Official would you like to attend the event?
*
Assessor
District Attorney
Sheriff
Supervisor Mike Wasserman - District 1
Supervisor Cindy Chavez - District 2
Supervisor Otto Lee - District 3
Supervisor Susan Ellenberg - District 4
Supervisor Joe Simitian - District 5
Do you want the Official to speak at the event?
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Yes
No
Attire
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Formal
Casual
Contact Information
Requested By
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Title
*
Organization Name
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Contact Person
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Contact Phone Number (###) ###-#### or ###-###-####
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Contact Email
*
Event Information
Date of Event (mm/dd/yyyy)
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Type of Event
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Topic
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Materials Requested
Event Start Time (hh:mm am/pm)
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Event End Time (hh:mm am/pm)
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Location Address
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Phone Number at Event (###) ###-#### or ###-###-####
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City
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Description of Audience
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Estimated Turnout
*
Media Invited
*
Additional information or comments
Please contact me via
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Phone
Email
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