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Event Request

Complete and submit this form to request my appearance at a speaking or non-speaking function. Due to scheduling demands, not all requests may be filled.

**Please note due to current public health concerns surrounding the coronavirus, Congressman Thompson and his staff are conducting “no contact” meetings. In an abundance of caution, we are also asking people to stay home if they are sick. If you are sick and it’s an urgent matter, we are happy to schedule a phone meeting.

Required fields are followed by *.

Your Contact Information
Prefix

First Name * First Name is required.

Last Name * Last Name is required.

Suffix

Email Address * Email is required. Invalid Email format.

Organization Name * Organization Name is required.

Contact Phone Number * Contact Phone Number is required. Phone number must be 10 digits.

About the Event
Event Name * Event Name is required.

Street Address * Street Address is required.

City * City is required.

State *

Zip Code * Zip is required. Zip has to be a number.

Event Date * Event Date is required.

Event Time * Event Time is required.

Dress Code

Number of Attendees

Event Background

Requested Role

Type of Appearance

Introduced By

Other Speakers

Speaking Arrangements Head Table
Lectern
Stage
Mic
Podium

Who is the MC?

Is a biography needed? Yes
No

Is a photo needed? Yes
No

Is the event open to the public? Yes
No

Will press be in attendance? Yes
No

Additional Information