Contact First Name

Contact Last Name

Organization

Title

Email

Phone

Zip Code

Event Description

We invite the County Executive to be our

If "other" please describe

Event Title or Name

Date of Event

Location of Event

Time of Event

Time Commitment

Subject of Event

Please Describe, if other

Special Guests in Attendance?

Past Participation by County Executive

Media Attendance

Please Describe Focus of Speech

Estimated Audience Size

How Much Time for Questions?

Mic & Podium?

Who will introduce the County Executive?

Do you require a headshot of the County Executive for this event? (If so, we will provide one for you)

Link to Event Website

Parking Information

Additional Information

"Day Of Event" Contact Name

"Day of Event" Contact Phone Number