Meeting Request Form

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Suggested Meeting Time:
Topic of Meeting:
Is this your first time requesting a meeting?:	YesNo
Have you met with the mayor or other City Hall representatives before?:	YesNo
If yes, who, when and of what topic?:
Have you contacted 630-CITY?:	YesNo
If yes, then please tell us your MyJax Service Request number:
Contact Information
Name of Contact:
Phone:
Email:
Home Address:
Is this a personal or business related request?:	PersonalBusiness
If business related, are you requesting on behalf of any organization?:	YesNo
If yes, which one?:
Number of Attendees:
Briefly summarize your objective for this meeting:
Attachment 1:
Attachment 2:
Attachment 3:

City of Jacksonville