Utah Governor Gary R. Herbert

Governor Herbert Request Form

Group or individual(s) making request:
Phone:
Email Address:
Fax:
We invite Governor Herbert to be our:
Date and time:

Event Details
Location: (include address, building, room number, and entrance)
Description of event:
Purpose of Governor Herbert's involvement:
Who will be in attendance? (Be sure to include any special guests you have invited, as well as an approximate head count.):
Is press/media involved? In what capacity?:
What is the dress?:
Please provide the following information:	(An itinerary of the event, driving directions, if applicable, talking points about your organization/group/initiative, any other important information ):

Speech Details
Topic:
Length of speech:
Microphone:	Yes No
Podium:	Yes No
Will anyone introduce him? Who?:
Who else is speaking/performing?:

Introduction:

Background Information:

Please list relevant information regarding the organization/group/event and why it is important the Governor is addressing the audience on this occasion.

Issues:

Please provide very detailed information about the subject matter including statistical information, positive or negative changes on these issues within the past five years, projected future impact, etc.

We do not schedule anything more than six weeks in advance. Once we receive your request we will review it at the appropriate time.
Within two weeks of receiving your request we will notify you about Governor Herbert's availability (unless you have submitted the request more than six weeks in advance). If you have not been contacted within that time, please contact Andrea Hansen at andreahansen@utah.gov
Please keep in mind that Governor Herbert's schedule may change at any time, based on current state needs and responsibilities at the time. If this occurs, we apologize for any inconvenience and appreciate your understanding.
Any press releases, sound bytes, printed material, etc that use Governor Herbert's name or quotes must be approved by the Office of the Governor before being distributed. If you are unwilling to do this, the Governor will be unable to participate in your event. Submission of this form indicates that you understand and accept these terms.
A brief biography of Governor Herbert is available.