SCHEDULE REQUEST

SCHEDULE A MEETING

Please note, this page is to be completed if you are requesting a meeting with Rixys Alfonso. To invite the Rixys Alfonso to participate or speak at an event, please complete our office’s official speech and event request form

Attendees: Please type the names and titles of all attendees

Organization (Please type of the name of the organization meeting with the Rixys Alfonso.):*
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Name*
Organization Contact's First Name:* Organization Contact's Last Name:*
Title:*
Are you a Non-Profit:
- Yes
- No
Work Phone:*
Cell Phone:*
Home Phone:*
Email*
Meeting/Event Details
Specific Topic/Issues:**
Desired location for the Meeting:*
Event Date (specify all available dates):*
Specific Topic/Issues:*
Description: Please include relevant specific topics you intend to discuss with the Rixys Alfonso.*
Attendees: Please type the names and titles of all attendees.*
Previous Meeting? Have you met with the Rixys Alfonso before?*

SCHEDULE A MEETING

Meeting/Event Details