Appearance Request – Lt. Governor Jacqueline Coleman
Appearance Request – Lt. Governor Coleman
Please provide the following information:
* Request for:
Governor
Lt. Governor
First Lady
* Second Request:
Governor
Lt. Governor
First Lady
Economic Development Cabinet Secretary
Education Workforce Development Cabinet Secretary
Energy and Environment Cabinet Secretary
Finance and Administration Cabinet Secretary
Health and Family Services Cabinet Secretary
Justice and Public Safety Cabinet Secretary
Labor Cabinet Secretary
Personnel Cabinet Secretary
Public Protection Cabinet Secretary
Tourism, Arts and Heritage Cabinet Secretary
Transportation Cabinet Secretary
Not Applicable
* Individual / Organization Making Request
* Point of Contact
* Address
* City
* State
(Select)
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District Of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
American Samoa
Guam
Northern Mariana Islands
Puerto Rico
U.S. Minor Outlying Islands
U.S. Virgin Islands
* 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
* Are you flexible with the date and time?
Yes
No
* Venue / Location
* Address
* City
* State
(Select)
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District Of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
American Samoa
Guam
Northern Mariana Islands
Puerto Rico
U.S. Minor Outlying Islands
U.S. Virgin Islands
* Zip Code
* Nature of Program
Include timeline and speaking order
* Will media be in attendance?
Yes
No
* Target Audience
* Number of attendees
* Event Attire
Formal
Business
Business Casual
Casual
* Food / Meal Provided
Yes
No
* Dignitaries or Speakers Participating (please note invited or confirmed)
Event Background Information (please provide a copy (PDF Format) of any news release and agenda, if available)
Organization and Event Website
Additional Notes
Security