Home Public Appearance Request Public Appearance Request Thank you for contacting the Office of the Arizona Secretary of State. Please provide the following information and you should receive a response within two weeks. Main Event Details Event Organization Event Date Event Time Event Location and Address or Virtual Event? Please state location and address or if it's a Virtual Event Contact Information Contact Information Name Email Please make sure your email is correct; you'll be receiving a confirmation email of your form submission. Phone Preferred Contact Method Email Phone Call Text No Preference Other Information Remarks Remarks can be entered at the end of this form. Yes No Kind of Speech Welcome Keynote Emcee Introductory Speaker Other… Enter other… Type of Setting Virtual Event Podium & Microphone Microphone Only Panel Other… Enter other… Office Representation? Yes No If the Secretary is not available, a representative from the office is requested. Topic Topic and length of time to speak Target Audience List other speakers Attendance Fee Is there a ticket cost or fee to attend? Yes No Fee Amount Expected Number of Attendees Media Invited Yes No Media Release Required Yes No Attire Formal Business Casual Office Additional Talking Points/Remarks Relevant Background Information Special Requests Expectations of the Secretary Additional information CAPTCHA What code is in the image? Enter the characters shown in the image. Submit Leave this field blank