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2. Important scheduling information:
   The First Selectman welcomes your meeting request at any time; however, our scheduling requires 2 weeks’ advance notice prior to the meeting date requested. First Selectman’s schedule may change at any time, based on emerging town needs and responsibilities. If last-minute schedule changes occur, we will notify you as soon as possible and attempt to reschedule.
4. Contact Information
8. First Name*
9. Last Name*
11. Address*
13. City*
14. State*
15. Zip Code*
17. Phone Number*
18. Fax Number
20. Email Address*
22. Name of Organization
24. Meeting Details
28. Please describe the subject of the meeting:*
30. This request is for a meeting:*

    1. At the First Selectman's office
    2. At a different location
32. Location (if not at the First Selectman's Office):
34. Address
36. City
37. State
38. Zip Code
40. Meeting Details
    We would like to meet with the First Selectman on the following date and time:
42. Date and Time Requested:*
    Date and Time Requested:

    Date and Time Requested:
43. Is the date flexible?*

    1. Yes
    2. No
44. Is the time flexible?*

    1. Yes
    2. No
46. Meeting duration*
    -- Select One --15 minutes30 minutes1 hourOther
47. Has the First Selectman met with you or your group in the past?*

    1. Yes
    2. No
48. Audience size:*
50. Who will be attending the meeting?*
    Be sure to include any special guests you have invited, as well as an approximate head count.
52. Additional information
Leave This Blank:


54. 1. Receive an email copy of this form.
55. Email address

    This field is not part of the form submission.

56. Submit

* indicates a required field