Schedule a Meeting

Speaking Engagement

To request a speaking engagement, please fill out this form and send it to our office at

• Email: wilson.dcschedule@mail.house.gov
• Fax: (202) 226-0777
• Mail: 208 Cannon HOB Washington, DC 20515

* indicates required field.

Contact Information

Organization:

Prefix:

First Name:*

Middle Initial:

Last Name:*

Suffix:

Street Address:*

Address 2:

City:*

State:* North Carolina Alaska Alabama Arkansas Arizona California Colorado Connecticut District of Columbia Delaware Florida Georgia Hawaii Iowa Idaho Illinois Indiana Kansas Kentucky Louisiana Massachusetts Maryland Maine Michigan Minnesota Missouri Mississippi Montana North Dakota Nebraska New Hampshire New Jersey New Mexico Nevada New York Ohio Oklahoma Oregon Pennsylvania Puerto Rico Rhode Island South Carolina South Dakota Tennessee Texas Utah Virginia Vermont Washington Wisconsin West Virginia Wyoming

Zip Code:* +4 (Determine your ZIP+4)

E-mail Address:*

Telephone Number:*

Meeting Request Details

Subject of Meeting:* Please select one: Agriculture Budget Defense Economy Education and Labor Energy Environmental Government Reform Health Homeland Security Immigration International Relations Judicial Social Issues Social Security Taxes and Trade Telecommunications Transportation Veterans Welfare Other

Desired Meeting Location:* Please select one: District Office Washington, DC

Will there be anyone from the district in the meeting?:* Yes No

If so, who?:

Are you seeking a meeting with one of her staffers, or either?:*

Preferred Date/Time:*

Alternate Date/Time :*

Subject/Issue/Legislation to be discussed in Meeting :*