Voter Education & Outreach Event Request

Please submit this form at least three weeks prior to the requested date; attendance/resources are subject to availability.

Todays Date:

Your Email Address:

Your Phone Number:

Organization Information

Organization Name:

Organization Email:

Organization Phone Number:

Event Name:

Facility Name:

Event Date:

Set-Up/Load-In Time:

Start Time:

End Time:

Press/Media Present:

Number Of Expected Attendees:

Target Audience:

Briefly Describe Event:

Booth/Tent Location:

Are The following Available At The Event (check all that apply)?

6 Foot Table (minimum 1)

8 Foot Table (minimum 1)

Chairs ( minimum 2)

Tent (10x10)

Electrical Outlet

Food/Meal

N/A

Requested Topics and/or Programs (check all that apply):

Voter Registration Drive Information

Voting Equipment Demonstration

Overview of Voter Registrations & Elections Processes

Poll Worker Recruitment

Absentee and/or Advance Voting

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