Community Affairs Division

Request Form

All information below is required except where indicated.
Incomplete forms may delay processing.
All requests are subject to staffing availability.
Due to prior staffing assignments, requests received within four weeks of an event cannot be processed. Mahalo for understanding.
NOTE: We are unable to schedule speakers or events from October 31st to November 20th due to other staffing requirements.

	Requestor
	E-mail
	Organization

	Organization Address

	Event Description

	Event Location

	Contact Person

	Contact Telephone Number

	Contact E-mail Address

	Services Requested
	Requested Date And Time

	Alternate Dates And Times (optional)
	Number of Persons Attending
	Number of Persons and their Ages if Under 18

	Special Requirements (optional)

	Additional Information (optional)