Scheduling Request

dlfaison

Submitted by dlfaison on Mon, 08/02/2021 - 17:27

Please complete the form below to send a scheduling request to the Governor.

Fields marked with an asterisk (*) are required.

Note: filling out the request does not guarantee the Governor’s participation.

Indicates required field

Requestor Name

Requestor Email

Requestor Cell Number

Requestor Office Number

Type of Invitation/Request

Meeting

Event

Meeting Form

Requestor Company/Organization

Meeting Date

Meeting Purpose

Meeting Attendees

Are you willing to meet with staff if Governor is not available?

Yes

Event Form

Host Organization

Event Name

Event Summary

Please provide a brief summary of the event

Event Date

Event Start Time

Event End Time

What is the Venue Name?

Is the event indoors or outdoors?

Indoor

Outdoor

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

County

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

Is the contact person at event the same as Requestor

Yes

Type of Event

Annual Meeting

Conference

Press Conference

Tour

Other type of event …

Estimated Number of Attendees

Audience Description

Dignitaries Attending

Name	Title
Name	Title

Is event open to the public?

Yes

Do you plan to invite media?

Yes

Purpose of Governor’s Role

What is Governor's level of participation?

Time and Duration of Remarks

Speaking Format

Keynote

Brief Remarks

Roundtable

Other speak format…

Who will introduce the Governor?

List other speakers and order in which they will speak

Name	Title	Topic
Name	Title	Topic

Are you willing to have staff or another member of the administration participate if Governor is unable to attend?

Yes

Supporting material such as an invitation, program or biographies can be emailed to scheduling@nc.gov. Please indicate the name and date of your event in the subject line.