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Event Request Form (Community Engagement)
Organization Name
Contact Name
Phone Number
Email Address
Event Start
Event Start: Date
Event Start: Time
Event End
Event End: Date
Event End: Time
Number Of Attendees Expected
1-25
30-75
100+
Other…
Enter other…
Type of Request
- Select -
Career Day
Community Day & Event
Fire/Safety Presentation
Hands-Only CPR
National Night Out
Risk Reduction Table
Other
Event Location Name
Event Location Address
Address
Address 2
City/Town
State/Province
- None -
Alabama
Alaska
American Samoa
Arizona
Arkansas
Armed Forces (Canada, Europe, Africa, or Middle East)
Armed Forces Americas
Armed Forces Pacific
California
Colorado
Connecticut
Delaware
District of Columbia
Federated States of Micronesia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Marshall Islands
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
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New York
North Carolina
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Northern Mariana Islands
Ohio
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Oregon
Palau
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Puerto Rico
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South Carolina
South Dakota
Tennessee
Texas
Utah
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Virgin Islands
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Alberta
British Columbia
Manitoba
New Brunswick
Newfoundland and Labrador
Nova Scotia
Northwest Territories
Nunavut
Ontario
Prince Edward Island
Quebec
Saskatchewan
Yukon
ZIP/Postal Code
Please provide a short description of your meeting or event
Is this your first time hosting an event?
Yes
No
Is this an indoor or outdoor event?
Indoor
Outdoor
Both (indoor and outdoor)
Have you discussed this event with other County agencies? If yes, please list.
Yes
No
Please List the Agencies
Is there an exhibitor fee?
Yes
No
Councilman District
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District 2
District 3
District 4
District 5
District 6
District 7
District 8
District 9
You can find your
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Event Flyer
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