Request A Meeting You must have JavaScript enabled to use this form. Form Type Selection Fieldset Indicate One Meeting Request Event Invitation Speaking Request Meeting Request To schedule a meeting with Speaker Rivas, please submit the following scheduling request form.Due to the large volume of requests, please allow up to ten business days for processing. Event Invitation Request To invite Speaker Rivas to attend an event, please submit the following scheduling request form.Due to the large volume of requests, please allow up to ten business days for processing. Speaking Request To invite Speaker Rivas to provide remarks, please submit the following scheduling request form.Due to the large volume of requests, please allow up to ten business days for processing. Contact Information Name of Organization/Person As a lobbyist firm, are you requesting this meeting on behalf of the firm or on behalf of the client, if client, please provide the name of that organization. Please tell us a briefly about your organization (include website if available) Contacts Contacts Contacts First Name MI Last Name Email Address Additional Emails 2nd Email Address 3rd Email Address Address 1 Address 2 City State - Select State -ALAKAZARCACOCTDEDCFLGAGUHIIDILINIAKSKYLAMEMDMAMIMNMSMOMTNENVNHNJNMNYNCNDOHOKORPARISCSDTNTXUTVTVAWAWVWIWY Zip Zip+4 Primary Phone Ext Additional Phone Number Additional Phone Ext Phone Type? Phone Type - None -MobileOfficeFaxOther Type Other Meeting Request Form Purpose of the Meeting If this meeting is about current legislation please provide the Bill #, author, and current location of the bill (if you have that information): Topic/Purpose of Meeting Please be concise; additional details can be provided. Issue to be Discussed Bills Bills Bill Type - None -ABSB Bill Number Bill Position Enter your position here. Attendees Attendees Attendees Name Title Represents Attendee is Constituent Constituent Address Additional Information Regarding Attendees Event Request Form Purpose of the Event Event Title The name of the event (e.g. tour, reception, community event etc.). Purpose of Event Please be concise; additional details can be provided in Event Logistics section Role for Speaker None Resolution Letter Honorary Host Committee Other Approximate Number of Attendees Attendees/Audience Description (Name, title, whom they represent) Has the Press or Media Been Invited To Attend? Yes No List the Press and Media organizations that will be present Additional Information About Event Speaking Request Form Purpose of the Speaking Request Purpose of Speaking Request Please be concise; additional details can be provided in this section. Our office asks that requests for appearances and speaking be made a minimum of 30 days in advance. This allows sufficient time to review requests and determine availability. Thank you in in advance. What Topic(s) should Speaker Rivas focus on? Include position represented by attendees Speaking Request Type Speaking Request Type - Select -SpeechPress ConferencePanelOther Other type Please Provide the Names of the Moderator and Other Invited Panelists Approximate Number of Attendees Additional Information About the Speaking Engagement Speaking Engagement Details Length of Speech (minutes) Maximum of 5 minutes Program Time During the program, what time will Speaker Rivas go on? Who will be introducing the Speaker? Are there other Guest Speakers? Yes No List Other Speakers List Other Speakers Name Title Confirmed Yes No Additional Details regarding other speakers What will the setup be (theater style, round tables, stage/riser, etc.)? Will there be a podium with an attached microphone? Yes No Has the Press or Media Been Invited To Attend? Yes No List the Press and Media organizations that will be present Date/Time & Location Has the Date & Time been determined? Yes No Select Dates and Times for this Request You may indicate preferred date ranges and/or specific dates for this request. Date Ranges (any date within the date range) Specific Dates (list up to 3 dates) Specify the Date & Time Start Date/Time Start Date/Time: Date Start Date/Time: Time End Date/Time End Date/Time: Date End Date/Time: Time Preferred Date & Time Range(s) Start Date End Date Preferred Times Preferred Times Preferred Times List the Preferred Date Range(s) for this request Specific Date & Time Date & Time Date & Time Date & Time Date & Time: Date Date & Time: Time Minutes can only be set in 15 minute intervals (e.g. 1:00 PM, 1:15 PM, 1:30 PM) List specific dates and times to request Flexible to Change Yes No Additional notes about the dates or times Preferred Location of Meeting Capitol Office District Office Virtual Meeting Other Location Setting Indicate whether the event is indoors, outdoors, or virtually held. Indoors Outdoors Virtual Location of Request Description/Name of Location Address Address 2 City State - None -ALAKAZARCACOCTDEDCFLGAGUHIIDILINIAKSKYLAMEMDMAMIMNMSMOMTNENVNHNJNMNYNCNDOHOKORPARISCSDTNTXUTVTVAWAWVWIWY Zip Location is outside of country Province/Region Postal Code Country - None -AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua & BarbudaArgentinaArmeniaArubaAscension IslandAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia & HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBritish Virgin IslandsBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCanary IslandsCape VerdeCaribbean NetherlandsCayman IslandsCentral African RepublicCeuta & MelillaChadChileChinaChristmas IslandClipperton IslandCocos (Keeling) IslandsColombiaComorosCongo - BrazzavilleCongo - KinshasaCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d’IvoireDenmarkDiego GarciaDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard & McDonald IslandsHondurasHong Kong SAR ChinaHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacao SAR ChinaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmar (Burma)NamibiaNauruNepalNetherlandsNetherlands AntillesNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorthern Mariana IslandsNorth KoreaNorth MacedoniaNorwayOmanOutlying OceaniaPakistanPalauPalestinian TerritoriesPanamaPapua New GuineaParaguayPeruPhilippinesPitcairn IslandsPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaRéunionSamoaSan MarinoSarkSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia & South Sandwich IslandsSouth KoreaSouth SudanSpainSri LankaSt. BarthélemySt. HelenaSt. Kitts & NevisSt. LuciaSt. MartinSt. Pierre & MiquelonSt. Vincent & GrenadinesSudanSurinameSvalbard & Jan MayenSwedenSwitzerlandSyriaSão Tomé & PríncipeTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad & TobagoTristan da CunhaTunisiaTurkmenistanTurks & Caicos IslandsTuvaluTürkiyeU.S. Outlying IslandsU.S. Virgin IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamWallis & FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Location Details Details about the venue, parking, and/or anything related. What is the attire for the event? Business Casual Formal Other Attire Enter other… Meeting Link URL Provide a meeting address link if applicable. (Zoom, Teams, etc.) Platform Platform N/AZoomTeamsWebexGoogle MeetOther platform Enter name of video conference platform File Attachments Attach Background Information? Choose files Info, Agendas, etc. Info, Agendas, Flyers, etc. Info, Agendas, Speaking Points, etc. Submission Information I am submitting this request on behalf of someone Name of Person Submission Information Please provide 48 hour advance notice if there are any changes to the list of attendees. Hidden Elements District ID Leave this field blank
