Invite Lt. Governor Susan Bysiewicz to an event

Online Invitation Form for Lt. Governor Bysiewicz

This online form has been designed to provide you with a convenient way to invite Lt. Governor Bysiewicz to an event. We ask for your patience as we cannot make commitments more than 30 days in advance of an event.

Fields marked with an asterisk (*) are required fields

Name Prefix Requestor First Name * This field is required. Requestor Last Name * This field is required Name Suffix Home Phone Number * Please add a valid home phone number. Business Phone Number Please add a valid phone number [ 000-000-0000 ]. Cell Phone Number Please add a valid phone number [ 000-000-0000 ]. Email Address * Please add a valid email address.

Address Information: Street Address: * Please add your street address. City * Please add your city.

Start typing and you can select a city from the dropdown.

State * Please add the state. Zip Code * A valid Zip Code is required.

Event Information: Event Type * Please select an event type. Event Name * The event name field is required. Date of Event * Please add the date of the event.

At least 4 weeks from request date and no more than 90 days from request date.

Sponsoring Organization * Please enter the sponsoring organization. Start Time of Event * Please add the start time of the event. End Time of Event * Please add the end time of the event.

Will there be additional speakers?* Yes No Please let us know if there are additional speakers

Event Street Address * Please add the event street address. Event City * Please add the event city.

Start typing and you can select a city from the dropdown.

Event State * Please add the event state. Event Zip Code * A valid Event Zip Code is required.

Event Honoree (if applicable) Event Description (250 characters max) * Please add the description of the event. Role of the Lt. Governor in the Event (250 characters max) * Please add the role of the Lt. Governor,

About the Audience (250 characters max): * Please advise on the composition of the audience. For example, will the audience be business people? Teachers? Employees? Are there any issues that are of interest to the audience that they would like the Governor to address? (250 characters max) * Please add information about the audience.

Is the Event open to the press?* Yes No Please indicate if this event is open to the press.

Expected Number in Attendance * Please select the number in attendance.

Attachments:

Files must be in PDF, Microsoft Excel (.xls or .xlsx) or Microsoft Word (.doc or .docx) format.

Upload Attachment 1

Upload Attachment 2

Upload Attachment 3

Please note: Electronic mail submitted through this web-site may be considered 'Public records or files' as those terms are defined in the Connecticut Freedom of Information Act, (the 'Act'). By operation of the Act, public records and files may be the subject to disclosure to persons other than the addressee. The marking of an electronic mail message submitted through this web site as 'personal' or 'confidential' may not prevent disclosure of certain public records governed by the Act.

Online Invitation Form for Lt. Governor Bysiewicz

Thank You!