Complete and submit the form below to request the Member’s appearance to a speaking engagement, or attendance at a function. Due to the Member's schedule, not all requests will be filled.Current Page 1 Page 2 Page 3 Page 4 Complete Indicates required field Activity DetailsType of Request:- Select -Speaking RequestAppearance (non-speaking)Location of Event:- Select -In DistrictIn Washington, DC or elsewhereBuilding name and/or full street address:Event Date:MonthMMJanFebMarAprMayJuneJulyAugSepOctNovDecDayDD01020304050607080910111213141516171819202122232425262728293031YearFirst Date Available:MonthMMJanFebMarAprMayJuneJulyAugSepOctNovDecDayDD01020304050607080910111213141516171819202122232425262728293031YearLast Date Available:MonthMMJanFebMarAprMayJuneJulyAugSepOctNovDecDayDD01020304050607080910111213141516171819202122232425262728293031YearDo you have any Additional Information About your Availability?Preferred Start Time:Number of Attendees:How many attendees are constituents of Kansas’ 3rd District?Who is the Sponsor/Host of the Event?Day of Contact Cell Phone Number:Topic of Engagement:Details and Discussion Topics:Is this Event Open to the Press?- Select -YesNoIs there a Speaking Program?- Select -YesNoWill this Event be Filmed?- Select -YesNoWill there be security?- Select -YesNoWho Will Introduce Representative Davids?Please List the Order of SpeakersWhen Would You Expect the Program to End?Please Describe Representative Davids’ Role:What is the Overall Set Up of the Event? CAPTCHA: enabled to secure this form. If you are having difficulty using Captcha's visual option, please visit Accessibility page for more assistance.