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2. Are you hosting an event where you would like our Town Officials to attend? Please complete this form and specify which Town Official(s) you would like to have at your event. Town Staff will respond to your request within 48 hours.

4. First Name*
5. Last Name*
7. Date and Time of the event*
   Date and Time of the event

   Date and Time of the event
8. Email*
10. Address of Event
12. City
13. State
14. Zip Code
16. Which Town Official(s) are you requesting?

    1. Mayor Jennifer Teague
    2. Councilwoman Altyn Cotell
    3. Councilwoman Diamond Staton-Williams
    4. Councilman Ian Patrick
    5. Councilman Ron Smith
    6. Councilman Rodney Dellinger
    7. Councilman Maurice Price
    8. Councilman Rick Russo
    9. Town Manager, Rob Donham
    10. Deputy Town Manager, Lee Connor
    11. Communications Team Member
17. Event Description*

    Please provide a brief description of your event.

18. Type of Event
    -- Select One --Ribbon CuttingSpeaking EngagementPersonal AppearanceSchool FunctionOther
19. Phone Number
Leave This Blank:


21. 1. Receive an email copy of this form.
22. Email address

    This field is not part of the form submission.

23. Submit

* indicates a required field