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Request an Appearance by the Mayor



City or Town:

State or Province:

Zip or Postal Code:



Event Information
* Event Type:

Is this a political or civic event?

* Name of Event:

* Date of Event:

* Location of Event:

* Name of Organization:

Organization Address:

* What time will the Mayor be expected to speak:

* How long will the Mayor Speak: 

* Audience Description and Size:

* Program Theme:

* What points would you like the mayor to address:

If this event is not in Des Moines, will transportation be provided?

Background Information
Is this an annual event?

Provide reference of any recent news articles for your event:

Speakers Outline:

Who are the other speakers:

Additional Information:

If you have any additional questions please contact Monica at (515) 283-4761.