Appearance Request – Governor Beshear

Please provide the following information:

* Request for:

* Second Request:

* Requested Role at the Event

Keynote speaker, Master of Ceremonies, etc.

* Individual / Organization Making Request

* Point of Contact

* Address

* City

* State

* ZIP Code

* Point of Contact Phone

###-###-####

Point of Contact Cell Phone

###-###-####

* Point of Contact Email

* Name of Event

* Event Date

##/##/####

* Event Start Time (please note time zone)

* Event End Time (please note time zone)

* Time of Appearance

* Preferred Length of Remarks (speaking time)

* Are you flexible with the date and time?

Yes

No

* Type of Event

Virtual

In-Person

* Venue / Location if in-person

* Address

* City

* State

* Zip Code

* Agenda of Program

Include timeline and speaking order

* Are you requesting a Governor’s proclamation related to the event?

Yes

No

If yes, would you like the proclamation signed at the event?

Yes

No

(See proclamation request web page.)

* Will media be in attendance?

Yes

No

* Target Audience

* Number of attendees

* Event Attire

* Food / Meal Provided

Yes

No

* Dignitaries or Speakers Participating (please note invited or confirmed)

* List any special recognition(s) the Governor should cite at the event

Event Background Information (please provide a copy (PDF Format) of any news release and agenda, if available)

Organization and Event Website

* Will this event be livestreamed and/or recorded?

Yes

No

If yes, please provide URL or website of livestream

Social Media Links

Does your organization have a Facebook and/or Twitter account to tag in pictures from the event? Please provide those links

* Equipment Requests

Do you have any special equipment needs beyond the appearance of the Governor? Examples include Team Kentucky backdrop, proclamation signing table, etc.

Additional Notes

Security

Contact Governor Beshear

700 Capital Avenue, Suite 100, Frankfort, Kentucky 40601
Main Line: (502) 564-2611
Main Fax: (502) 564-2517
Send an Email

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