Mayor's Scheduling Request Form


Thank you for contacting the Office of the Mayor.  If you would like to request a meeting or schedule an event with the Mayor, please complete the online form we have provided for your convenience.

You will be notified as soon as possible in regard to your request. Please understand that the Mayor’s schedule is subject to change. For questions concerning this form, please contact Misty Wells at misty.wells@mesaaz.gov

 

First Name


Last Name
Organization
Address
City, State  Zip


Work Phone (include area code)


Cell (include area code)
Fax (include area code)
Email
 

 

Meeting/Event Information

Day/Date of Event/Meeting


Event/Meeting Title
Location
Start Time (include AM or PM)


End Time (include AM or PM)
Address of Event/Meeting
Is this a Speaking Engagement (yes or no)

Time Mayor is speaking
Topic
Nature of Audience


Number of people in attendance
Event set-up (podium, stage, microphone, etc.)



Type and length of remarks





If other, please explain

Name of Keynote Speaker

Attire


Will the media be present? (yes or no)