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Columbus, Ohio 43231
Phone: (614) 523-2555
Fax: (614) 818-0887

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Fax: (202) 226-4523

 
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Home   /   Scheduling   /   Invite Me to an Event
Please provide the following information to request the Congressman attend your event. You will be contacted on or before your requested confirmation date. Please note, this form does not confirm the Congressman's attendance at your event. If you have any questions, please contact our office at 614-523-2555. Thank you for your interest and cooperation.
Name of Organization
Address of the Event
 
  (If appointment is accepted, you will need to provide written directions to the event)
*Contact Name:  
*Contact Telephone:  
Contact Cellular/Pager:
Contact Fax:
*Contact Email:  
Alternate Contact Name:
Alternate Telephone:
Alternate Cellular/Pager:
Alternate Fax:
Alternate Email:
Person Meeting Pat at the Event:
Location of Meeting Place:
Name of Event:
Date of Event
Month Day Year
Time of Event
Dress Code
(Business, Formal, Bus. Casual, Casual)
Number of Attendees:
Requested Role for Representative Tiberi:
Confirmation Date:
(i.e., the date by which you must receive a response)
Speech:
Duration of Speech:
 
Begin Time:
End Time:
Q & A Segment:
 
Time Alotted:
Location of Event:
(Please include city)
Topic(s) of Interest:
Who is Audience:
Representative Tiberi Introduced by:
Individuals/Organization(s) to recognize:
Other Speakers:
VIP/Elected Officials Attending:
Press Expected to Attend:
Podium:
Is this a Fundraising Event: