Rep. Karen Bass Speaking and Event Appearance Request Form

Thank you for your interest in inviting Representative Karen Bass (CA-37) to attend your event. Please complete the form below to submit your invitation. Please make your request no less than four weeks in advance. We will follow up with you as soon as possible.

Please note that this form is solely for event invitations and speaking requests. For meeting requests, please visit bass.house.gov/meetingrequest.

For all media or interview-related inquiries, please contact Zach Seidl at Zachary.Seidl@mail.house.gov.

If you have any questions, please do not hesitate to contact our office directly at (202) 225-7084.

Thank you again,

Office of Representative Karen Bass (CA-37)

Required

Organization

Name(s) of individual and/or organization:

Provide brief background information of the individual and/or organization (100-word max):

Event Details

Name of event:

Please provide a description of the event, including the event theme, purpose, and other invited special guests (200-word max):

Venue Name & Address (Please provide a room or suite number if applicable.):

Date of event:

Event Commencement:

Event Conclusion:

Requested arrival time:

Description of Member's role:

If other, please provide the Member's role here (100-word max) :

Are you requesting remarks from Representative Bass?

If yes, expected speaking time:

If yes, expected speaking duration:

If yes, specific topic of remarks:

Estimated number of audience attendees:

Please provide a brief description of the audience composition (e.g. students, organization members, constituents, etc.) (100-word max):

Is this event invite-only or open to the public?

Please Check all that apply

Live-streamed

Recorded

Open to the Press

Attire:

Other Attire:

Event Contact

Event organizer name:

Event organizer phone/Phone Type:

Event organizer email:

Day of event contact name:

Day of event contact phone/Phone Type:

Day of event contact email: