2. Use this form to request the Mayor's or a Council Members participation in a video. Please note that requests must be submitted two weeks in advance.

   Contact Kayla Samek (281-275-2313) for additional questions.

4. Name of individual or entity making the request*
6. Phone Number*
7. Email*
9. Information on Company/Organization
   If applicable, please provide background information on your organization/company. This can include history, years in Sugar Land, etc...
11. Who are you requesting?

    You can select more than one.

    1. Mayor Joe R. Zimmerman
    2. Council Member William Ferguson
    3. Council Member Jennifer J. Lane
    4. Council Member Suzanne Whatley

    1. Council Member Naushad Kermally
    2. Council Member Stewart Jacobson
    3. Council Member Carol K. McCutcheon
    4. Mayor and all City Council Members
13. If the Mayor is unavailable, would you like a Council Member appear in his place?

    1. Yes
    2. No
15. Who is the intended audience for this video?*
16. What will the elected official be expected to say?*
18. What type of attire will be appropriate for the video?*
19. Date the video will be needed
    Date the video will be needed
21. Describe the event/function in which the video will be shown*
23. Additional comments
25. Acknowledgement #1*

    1. I understand that speaking engagements that are technical in nature or pertain to the day-to-day operations of the City may be more appropriate for a City staff member to present.

    Please email citymgr@sugarlandtx.gov to request a city staff member attend or speak at your event.

27. Acknowledgement #2*

    1. I understand that the video may be filmed with a phone or web camera.
29. Acknowledgement #3*

    1. I understand that the availability of elected officials is not guaranteed.
31. Acknowledgement #3*

    1. I understand that the request must be submitted two weeks in advance of the event or function.
Leave This Blank:


32. 1. Receive an email copy of this form.
33. Email address

    This field is not part of the form submission.

34. Submit

* indicates a required field