Required fields are marked with asterisks (*)

Event Request Form

Please use this form to invite the Durham Regional Chair to an event. Due to a busy schedule and Regional obligations, the Regional Chair is not able to accept every invitation.

Requester Details

First Name

Last Name

Organization Name

Telephone Number

Website

Event Overview

Event Name

Event Date

Event Start Time

Event End Time

Short Description of Event

Full Street Address of Event

City, Postal Code

Number of people attending

Please attach any additional information (e.g., Formal Invitation, Letter, Supporting Material, Event Flyer, Agenda, etc.)

Browse…

Allowed extensions pdf, doc, docx, xls, xlsx, jpg, jpeg, gif, png, tif

Event Details

Other special guests invited or attending

Event Contacts

Contact person #1 during event

First and Last Name

Phone number

Contact person #2 during event

First and Last Name

Phone number

The personal information collected on this form is collected under the authority of the Municipal Act and will be used to process requests and for statistical reporting. If you require assistance, please contact the Regional Chair's office at 905-668-4113. ext. 2001, or by email at chair@durham.ca.