Request City Council Member at an Event

2. To request the Mayor or any member of City Council to attend and/or speak at your event, please complete the information below. Completion of this form does not confirm the attendance of the Mayor or any member of City Council at your event. A staff person will contact you to advise of their availability. For questions regarding a request, please contact the City Clerk’s Office at 757-926-8634.

   To request the Mayor or any member of City Council to attend and/or speak at your event, please complete the information below. Completion of this form does not confirm the attendance of the Mayor or any member of City Council at your event. A staff person will contact you to advise of their availability. For questions regarding a request, please contact the City Clerk’s Office at 757-926-8634.

4. Name of Event*

6. Date and Time of Event*
   Date and Time of Event Start Date

   Date and Time of Event Start Time

   —

   Date and Time of Event End Date

   Date and Time of Event End Time

8. Name of Requested Public Official*

   1. No preference - any available would be welcome
   2. Mayor McKinley Price, DDS
   3. Vice Mayor Tina L. Vick (South District)
   4. Marcellus L. Harris III (North District)
   5. Sharon P. Scott, MPA (North District)
   6. David H. Jenkins (Central District)
   7. Dr. Patricia P. Woodbury (Central District)
   8. Saundra N. Cherry, D. Min. (South District)

10. Required Arrival Time*
    Required Arrival Time

12. Place/Address of Event*

14. Official Invitation

    Please upload the official invitation if available.

16. Name of Host Organization or Group*

18. Name - Event Contact Person*

    Prior to event.

20. Phone Number - Event Contact Person*

    Prior to event.

22. Email - Event Contact Person

    Prior to event.

24. Program

    Please upload a copy of the program if available.

26. Approximate Number of Attendees

28. Are you requesting a speaker?*

    1. yes

    1. no

30. Type of Public Address
    -- Select One --welcome addresskeynote address

32. Please provide details/topic of speech.

34. Length of Speech

36. Start Time for Remarks*
    Start Time for Remarks

38. Where should the public official park?

40. Name - On-site Contact*

42. Phone Number - On-site Contact*

44. Name of individual(s) who will be in attendance and should be recognized.*

    e.g. president, chairman

46. Additional information including history of organization or group.

    Please provide any pertinent details on the event you feel would be helpful.

48. Will the event be televised, recorded or photographed?*

    1. yes

    1. no

Leave This Blank:


49. 1. Receive an email copy of this form.
50. Email address

    This field is not part of the form submission.

51. Submit

* indicates a required field