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Event Name *

Please briefly describe the event and the audience. *

Event Location *

Event Address, Line 1 *

Event Address, Line 2

Event City *

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What time would the Congresswoman arrive? *

What time would the Congresswoman speak? *

Who would meet the Congresswoman upon arrival? *

Who would introduce the Congresswoman? *

Please specify your expectations of the Congresswoman. *

Speech

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Q&A;

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Please briefly describe the speech topic, length, etc.

Please list any speakers before and after the Congresswoman.

Will a meal be served? *

Please list any other dignitaries or guests.

Is the event open to the public and/or the press? *

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I am always pleased to hear about upcoming events that might be of interest to me or my staff.

To request my attendance at an event in Kansas or in Washington, D.C., please complete the form below.

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Veterans History Project Interviewer Sign Up

My office is compiling a list of Kansas Second District residents who are willing to interview local veterans for the Veterans History Project. If you are interested in participating, please fill out the form below. (If you are a veteran who is willing to be interviewed, please use this form instead.)

After you complete the form below, a member of my staff will contact you via e-mail, and we will attempt to find an area veteran (or, if you're willing to conduct multiple interviews, several veterans) for you to interview. If you have previously submitted this form and your contact information has changed, please submit a new form.

For more information about the Veterans History Project, please visit the project's website or read the participant field kit.

Thank you for doing your part to preserve our nation's history!

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Salutation:

First Name:*

Middle Initial:

Last Name:*

Date Of Birth:

Gender:

Home Phone:*

Work Phone:

Mobile Phone:

E-mail Address:*

Address:*

City:*

State:*

Zip Code(5-Digit):*

Are you interested in participating in the Veterans History Project as an individual or as part of a group or class project?

Individual

Group project

Class project

Have you ever conducted an interview for the Veterans History Project before?

Yes

Do you have any audio or video equipment to conduct an interview? If so, please describe:

If you would like Rep. Boyda's office to put you in contact with veterans to interview, please describe any particular requests for your interviewee's geographic area, time of service, etc.

Please provide a brief description of your interest in the Veterans History Project.

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TOPEKA, KS OFFICE 510 SW 10th Avenue Topeka, KS 66612 Phone: (785) 234-8111 Fax: (785) 234-9111	WASHINGTON, D.C. OFFICE 1711 Longworth House Office Building Washington, D.C. 20515 Phone: (202) 225-6601 Fax: (202) 225-7986	PITTSBURG, KS OFFICE 701 N. Broadway, Suite A Pittsburg, KS 66762 Phone: (620) 231-3011 Fax: (620) 231-4011

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