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 Mayor Scott Smith, 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 Mayor Smith’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)