| * denotes a required field |
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| * Date of Event: |
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| *Hours of Event |
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| * Time Mayor is requested to attend Event: |
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| * Name of Event: |
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| * Name of Sponsoring Organization: |
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| * Address/Location of event: |
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| * Mayor's Requested Role: |
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| If Other: |
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| * In the event of a conflict with the Mayor's schedule, would you accept a Representative of the Mayor's Administration to participate on his behalf? |
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| * Your organization's contact person for event (title, mailing address, e-mail address, work phone number), *cell phone number, and fax number). Cell number is necessary in case of emergency or other day of event scenarios. |
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| * On-site Telephone Number: |
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| * Parking Instructions: |
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| * Who from your organization will greet the Mayor and/or his staff? |
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* Estimated number of people attending:
(attach guest list if available) |
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| * Elected officials and/or dignitaries (names and titles) confirmed to attend event: |
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| Email formal agenda to mayor@bridgeportct.gov, if available. |
| * Will the Mayor be introduced? |
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| If yes, who will introduce the Mayor? |
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| * List of people on the dais, if applicable: |
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| * Type of dress: |
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| If Other: |
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| * Requested topic of Mayor's speech/remarks: |
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| Requested length of Mayor's speech/remarks: |
Minutes |
| If applicable, please fax any pertinent information that may be useful to the Mayor in preparing his speech/remarks to (203) 385-4108. |
| * Will the press be invited? |
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| * If yes, will your organization/company handle media outreach? |
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| If yes, please detail which media outlets will be contacted. |
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| Please provide any additional information that will be helpful to the Mayor: |
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If you will be requesting a proclamation for your event,
please be sure to submit a form located under Additional Links.
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| Submitted by: |
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| * Full name: |
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| * Date: |
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| * Email address: |
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| * Cell/Primary Phone Number: |
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| Other Phone: |
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