Supervisor Ellenberg Meeting and Event Appearance Request

Event appearance request form for Supervisor Ellenberg

Event Name

Event Date

Event Time (total)

Event Location & Address (Put "virtual" if an online event)

Role for Supervisor Ellenberg

Event Purpose/Intention

Event Audience Description

Estimated Number of Attendees

Approximate Length of remarks by Supervisor Ellenberg (in minutes, specify if time allotted includes Q&A)

Topic(s) or desired theme of Supervisor Ellenberg's remarks

Agenda/Run of show (Specify whether draft or final)

Parking Information (Put N/A if event is virtual)

Commendation or Certificate Requested?

Event Contact Person Name

Event Contact Person Phone

Event Contact Person Email

Event Url or Website

Additional details (format, run of show, other speakers, whether there is a cost for attendees, etc.)

Supervisor Susan Ellenberg Meeting Appearance Request Form

Meeting Name

Meeting Date

Meeting Time (total)

Meeting Location & Address (Put "virtual" if an online event)

Role for Supervisor Ellenberg

Meeting Purpose/Intention

Meeting Audience Description

Estimated Number of Attendees

Length of Supervisor Speech

What Topics Should the Supervisor Focus On?

Has the Press or Media Been Invited to Attend?

Yes

Agenda/Run of show (Specify whether draft or final)

Parking Information (Put N/A if event is virtual)

Commendation or Certificate Requested?

Meeting Contact Person Name

Meeting Contact Person Phone

Meeting Contact Person Email

Meeting Url or Website

Additional details (format, run of show, other speakers, whether there is a cost for attendees, etc.)

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Event appearance request form for Supervisor Ellenberg

Supervisor Susan Ellenberg Meeting Appearance Request Form

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