Request Event Appearance

2. Event Information
4. Event Name*
5. Event Date*
   Event Date
6. Event Time*
   Event Time Start Time

   —

   Event Time End Time
7. Flexible Date*

   1. Yes
   2. No
9. Event Address*
11. Unit/Suite Number
12. City*
13. State*
14. Zip*
16. Estimated Number of People*
17. Type of Audience*
19. Organization & Contact Details
21. First Name*
22. Last Name*
24. Organization/Business*
25. Title*
27. Preferred Contact Phone Number*
28. Email Address*
30. About Your Organization *
32. Event Details
34. Day of Event Point of Contact Name*
35. Day of Event Point of Contact Number*
36. Day of Event Point of Contact Email*
37. Parking Details*
39. Tentative Run of Show*
40. Summary/Background of Event*
42. Judge’s Proposed Speaking Role*
    -- Select One --2 - 3 Minute Remarks5 Minute Remarks10 Minute Remarks15+ Minute RemarksPanel MemberGuest OnlyJudging Member
43. Is the Judge receiving an award?*

    1. Yes
    2. No
44. Please Describe Award Details

    Required Field

45. Items Requested by Event Organizer*

    1. Bio of County Judge
    2. Photo
    3. None
47. Theme of Event (if Any) and Key Points to Help Prepare Remarks*
49. Upload Supporting Materials
Leave This Blank:


50. 1. Receive an email copy of this form.
51. Email address

    This field is not part of the form submission.

52. Submit

* indicates a required field