| Name of Event | |
| Name and Phone Number of Organizer | |
| Email address | |
| Event Date, Time and Location | |
| Time of Formal Part of the Event | |
| Is the Mayor required to stay for the entire event? | Yes No |
| Is the Mayor required to bring greetings? | Yes No |
| Who else will be speaking at the event? | |
| If the Mayor is unavailable to attend, would you like a Councillor to attend? | Yes No |