Name of the Event

Date of the Event

Sponsoring Organization

Time of the Event

Start    End

Speaking Time

Location: Please provide the facility, street address, town and phone number

EVENT DESCRIPTION AND ROLE OF THE COMPTROLLER IN THE EVENT

Please provide a brief description or outline of the event in addition to a formal or proposed agenda.

Please provide some basic information about the role of the Comptroller in the event. For example, would you like her to serve as keynote speaker? Attend a groundbreaking? Take a tour? Meet with students?

ABOUT THE AUDIENCE

Please advise on the composition of the audience. For example, will the audience be businesspeople? Teachers? Employees? Are there any issues that are of interest to the audience that they would like the Comptroller to address?

Expected Number in Attendance
Select 1-10 10-30 30-60 60-100 100-200 200-500 500+

CONTACT INFORMATION

Your Name

Telephone Number
 

Mailing Address

E-Mail Address

Cell Phone Number
 

Fax Number