Meeting Request Form

Indicates required field

We will make our best effort to accommodate the requested date and time, however due to scheduling restraints that may not always be possible. The completion of this form is a scheduling request; meeting is not scheduled until you receive confirmation from the scheduler.

Contact Information

Prefix:

First Name:

MI:

Last Name:

Suffix:

Organization (If Applicable):

Phone Number:

Type:

Work

Cell

Home

Day of Phone (If Different):

Type:

Work

Cell

Home

Email:

Assistant Name (If Applicable):

Assistant Phone:

Assistant Email:

Meeting Information

Date:

Time:

Have you met with Congressman Fitzgerald or staff previously:

Yes

If yes, with who and regarding:

Purpose of meeting / Topics to be discussed:

Background / Information on organization (If Applicable):

Will you be distributing additional materials?

Yes

If yes, please attach documents:

Maximum 10 files.
2 MB limit.
Allowed types: txt rtf pdf doc docx odt ppt pptx odp xls xlsx ods.

Meeting Policies

Important Policies:

We do not allow for video or audio recording of any kind during virtual or in person meetings.
We do not permit photography without prior consent from staff.
Please notify the scheduler of any additional attendees prior to the meeting.
No gifts. Thank you for your understanding and compliance with this policy.
This meeting is subject to cancellation if you do not confirm with the scheduler 24 hours prior to the meeting.

I acknowledge and agree to the meeting policies listed above.

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