Office of the Mayor - Scheduling Form

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Scheduling Form

Scheduling Form

Contact Information

First Name		Last Name
Organization (if applicable)
Mailing Address: Please provide exact address
Street		City
State		Zip Code
Telephone: Work		Cell
Fax		Email
Meeting/Event Information
Date of Event	A value is required. Invalid format.	Start Time (pls specify AM or PM )
End Time(please specify am or pm)		Mtg Title
Event Location:
Event Address		Event City
Event State		Event Zip
Type of Function:

Event Description:
Please describe the basic nature and purpose of the event.
What would you like Mayor Nutter to do at this event? (speak, greet, etc.)
How many people do you expect to attend this event?

Instructions

If you would like to request a meeting with or schedule an event with Mayor Michael A. Nutter please complete the on-line form we have provided for your convenience. If you are unable to complete the form please send us a written request by

mail

City Hall
Office of the Mayor
Rm 215
19107

fax

(215-686-2180)

Please include your contact information:

name
address
telephone number
email address
the date of event
the start and end time of the event
the location of the event
the name of your organization
and a description of the event

Please note that we typically determine his availability two to four weeks from the date of the event or meeting.