Invite Me to an Event

Complete and submit this form to request Congressman Butterfield's appearance at a meeting, speaking function, or a non-speaking function. Due to the Member's schedule, not all requests will be filled.

* marks required fields of data.

Location of Event: *

Your Information

Event Organizer's Full Name *

Your Organization: *

Your Title: (i.e., President) *

Best Contact Phone Number *

Email: *

Activity Details

What is the date or date range of the event? *

Start Time *

End Time: *

What is the name of the event? (i.e., 2nd Annual Memorial Day Celebration) *

Describe the Event in Detail: *

Why is this event significant or relevant to Congressman Butterfield and/or the First Congressional District? Describe in detail the significance: *

Venue Information

Name of Venue? (i.e., Community Center) *

Street Address: *

Street Address Continued:

City: *

State: *

Zip Code: *

Other Details

How many people do you expect to attend the event? *

What would you like Congressman Butterfield's role to be? *

Other

Would you like Congressman Butterfield to give remarks? *

Yes

If so, how long?

If so, what are the key topics you would like him to address? Describe key topics and themes desired in detail. If you are not requesting remarks, please put "N/A" in the box below. *

Do you anticipate media coverage at the event? *

Yes

FOR NC EVENTS ONLY: If Congressman Butterfield is unable to attend, would you like a member of his staff to attend on his behalf? *

Yes

Upload invitation or agenda draft (This ONLY applies to event requests):

Files must be less than 2 MB.
Allowed file types: txt rtf pdf doc docx.

Your file size can not exceed 1MB. Documents must be the following file types: .doc, .docx, .pdf, .rtf, .txt

Mac users: Your document must have a file extension. Resave it using your word processor with the appropriate extension from the above list.

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Invite Me to an Event

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