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2. Name of event:
3. Date of event:
4. Start and end time of event:
   Start and end time of event: Start Time

   —

   Start and end time of event: End Time
6. Place/Address of event:
7. Hosting organization or group:
9. Point of contact name:
10. Point of contact email address:
11. Approximate No. of attendees:
13. Point of contact telephone number:
14. Name of requested Public Official(s):
18. Welcome Address:

    1. Yes
    2. No
19. Keynote Address:

    1. Yes
    2. No
20. Length of time for remarks, if applicable:
22. Start time for remarks, if applicable:
23. Required arrival time for Mayor/Council Member(s):
25. Please attach the following documents to this form:
    Official event invitation; Copy of draft event program; Historical information or additional information about event or organization
27. For further assistance, contact the City Clerk's Office at (540) 853-2541.
Leave This Blank:


29. 1. Receive an email copy of this form.
30. Email address

    This field is not part of the form submission.

31. Submit

* indicates a required field