Please fill out the following information with the event details you would like MDOS to present at. Please note that event requests regarding Redistricting should be made by contacting the MICRC Coordinator Edward Woods at WoodsE3@michigan.gov. Media, please contact Tracy Wimmer at WimmerT@michigan.gov.

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* 2. What is your name?

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* 3. What is your email?

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* 4. What is your phone number?

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* 5. What is the name of your Orgainization?

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* 6. What is the title of the event you intend to host

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* 7. Please provide a brief description of the event.

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* 9. Has a date and time been decided? If so, include them.

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* 10. Who is your target audience?  (demographic and geographic)

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* 11. How many attendees are you expecting?

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* 12. What information would you like presented by MDOS?

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* 13. What role will MDOS have in the event?  (cohost, presenter, etc)

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* 14. Are any other organizations co-hosting this event? If so, please list them and their contact information.

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* 15. Any additional event details.

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