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City Council speaker request form

Your first name
 *
Last name
 *
Name of your group / organization
 *
Email address where we can contact you to make arrangments
 *
Your phone number
 *

When and how often does your group meet?
Example: "the fourth Tuesday of every month"  --or -- "in 2020, our meeting dates are [insert the next 5-6 meeting dates]."

 *
Where does your group meet?  Please provide name of the location and full street address of the meeting location.
Example: "Bob Smith residence, 2215 Old Sedona Street, Sedona AZ 86336"  -- or --  "Olde Sedona restaurant, 1405 State Route 89A, Sedona AZ 86336."
 *
What topic would you like a council member to speak about? Check all that apply
What topic would you like a council member to speak about? Check all that apply
  1. To receive a copy of your submission, please fill out your email address below and submit.