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Event Request

To invite the Assemblymember to an event, please submit the following scheduling request form.

Due to the large volume of requests, please allow 5 business days before following up on the requests.

Date/Time

Event Title

Description

Location

Name

Address

City

Zip Code

Assemblymember's Role

Ticketed Event?

Yes

Media/Press Expected?

Yes

Speaking Engagement

Speech Topic

Length of Speech

Other Speakers

Q & A?

Yes

Contact Information

Name of Organization

First Name

Last Name

Address

City

State

Zip Code

Phone

Fax