Scheduling / Appearance Request Form

Event Title

Date of Event

Organization/Individual

Person Requesting

Type of Event

Time DA Howard Can Arrive / Depart

Address of Event

Has the Media Been Notified? Has the Media Been Notified? Yes No

Government Officials Attending

Has the Media Confirmed? Has the Media Confirmed? Yes No

Is this advertised on website or social media, if so where:

Expected Attendance:

Expected Attire:

Time of Speech

Length of Speech

Function of Speech Function of Speech Dedication Prayer Opening Remarks Speech Other (if other, we will get with you via email to find out your request)

Suggested Topic

Who Will Introduce:

Will There Be Q&A: Will There Be Q&A: Yes No

Contact Person:

Best Number to Reach Them:

Email

Will This Person Greet & Escort DA Howard: Will This Person Greet & Escort DA Howard: Yes No

If Not, then Who with Contact Number: