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Tele-engage Meeting Request Form

  1. If you do not have one, please provide the email address of a contact in your organization to whom we can provide details and updates for this Tele-engage request.
  2. (xxx) xxx-xxxx
  3. Which type of phone number?*
  4. Which of the following best describes your organization?*
  5. What is the primary purpose of your event?*
  6. Which of the following issues do you plan to discuss at the meeting?*
  7. Please briefly write what you plan to discuss at the meeting with the City Hall representative.
  8. Please select a preferred meeting date.
  9. 60 minute time slot between 4 - 8 PM only
  10. How many attendees do you expect?
  11. Will a majority of attendees be in the youth demographic? (ages 18-29)*
  12. Will a majority of attendees be of older age? (ages 65+)*
  13. From which of the following departments would you like a representative to attend?*
  14. Please type in his / her name.
  15. Will you need flyer or advertising support to publicize this meeting?*
  16. Do you have your own video conferencing link to use for the meeting?*
  17. Will you need assistance in video conferencing set-up?*
    Note: We require you to participate in a video conferencing training if you do not have your own conference link
  18. Leave This Blank:

  19. This field is not part of the form submission.