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2. Request for Mayor or City Commission Participation
4. General Event Information*

   Name of Individual and/or Entity Making the Request

6. Phone Number*
8. Email*
10. About the Company/Organization*

    This information will help us learn more about the company/organization. This can include history, mission, industry, years in Texas City, and/pr other relevant information. Include website links if possible.

12. Date and Time of the Event (Start to End)*
    Date and Time of the Event (Start to End) Start Date

    Date and Time of the Event (Start to End) Start Time

    —

    Date and Time of the Event (Start to End) End Date

    Date and Time of the Event (Start to End) End Time
14. Title of Event*
16. Event Location*

    Enter the exact location (address) of where the event will take place. If the event will be virtual, please indicate the online platform that will be used (e.g. Zoom, Teams, etc..)

18. Any promotional items available?

    If available, upload any flyer, program, or other resource about the event and your organization. 

20. Is the event*

    1. Invite Only
    2. Open to the Public
21. How many people are you expecting?*
23. Request Specifics
25. Who are you requesting?*

    You can select more than one.

    1. Mayor Dedrick D. Johnson, Sr.
    2. Commissioner At-Large/Mayor Pro Tem Thelma Bowie
    3. Commissioner At-Large Abel Garza, Jr.
    4. District 1 DeAndre' Knoxson
    5. District 2 Felix Herrera
    6. District 3 Dorthea Jones Pointer
    7. District 4 Jami Clark
26. Expected Arrival Time*
    Expected Arrival Time Start Date

    Expected Arrival Time Start Time

    —

    Expected Arrival Time End Date

    Expected Arrival Time End Time
27. Are spouses invited?*

    1. Yes
    2. No
29. Who is the Contact Person?*

    Who should be contacted with any questions on the day of the event? Include contact persons name, office, cell & work number.

31. Will the elected official(s) be expected to speak?*

    1. Yes
    2. No
32. Speaking Remarks Acknowledgement*

    1. I understand that if I am requesting elected officials to speak about a topic related to city operations, I need to provide written speaking remarks a week in advance of the event.
34. Will there be other speakers at this event?*

    1. Yes
    2. No
35. Photo Acknowledgement*

    1. I understand that if photos of my non-City sponsored event are needed, I must provide the photographer and camera to take the photo(s) The City is unable to provide photography services for events not directly sponsored by the City.
37. Acknowledgement #1*

    1. I understand that the availability of elected officials is not guaranteed.
39. Acknowledgement #2*

    1. I understand that the request must be submitted two weeks in advance to the event or function.
41. * Indicates a required field
Leave This Blank:


43. 1. Receive an email copy of this form.
44. Email address

    This field is not part of the form submission.

45. Submit

* indicates a required field