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Official Site of The State of New Jersey

Department of State

Ask the Secretary of State to your event by submitting a request. The red * denotes a required field.

Event Contact Person: *
Salutation
First Name
Last Name

Email Address: *

Preferred Phone Number: *

Other Phone Number: *

Event Title / Name: *

Location: * Address
Address line two
City
State
Zip Code

Date: *
/ /

Start Time: *
:

End Time: *
:

Is this date/time flexible? *
Yes No

Event Subject: *

Sponsoring Organization/Company: *

Event Purpose and Description: *

Type of Event: *

Intended Role: *

How long is the Secretary expected to speak? *

Number of Expected Attendees: *

Is the Event Open to Media? *
Yes No

Additional Information:

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