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Representative Shoaf - FL House District 7           Legislative Community Forum         Speaker Request Form

Representative Shoaf - FL House District 7           Legislative Community Forum         Speaker Request Form

Please complete this public speaker request form.  Be as detailed as possible so we can have all of your information on the speaker's agenda, prior to the meeting.
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    LEGISLATIVE COMMUNITY FORUM
    hosted by Representative Jason Shoaf
    FL House District 7


    Please complete this form if you or your organization wish to speak and/or present information at your local Legislative Community Forum. If you have any questions regarding the information requested on this form, please contact Representative Jason Shoaf's office at 850-295-5680. This form may also be accessed and submitted online at: https://form.jotform.com/203426093860050. 

    Please email this completed form any supporting documents by 12PM on September 10th, to: Jessica.Holley@myfloridahouse.gov

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    County Community Forum at which you wish to speak:
    County
    • County
    • CALHOUN County (7 PM EST on 9/14/2021)
    • FRANKLIN County (4:30 PM EST on 9/15/2021)
    • GULF County (7 PM EST on 9/15/2021)
    • JEFFERSON County (12 PM EST on 9/2/2021)
    • LIBERTY County (5 PM EST on 9/14/2021)
    • MADISON County (5PM EST on 9/2/2021)
    • TAYLOR County (12 PM EST on 9/14/2021)
    • WAKULLA County (12 PM EST on 9/15/2021)
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    Only fill out if you answered 'YES' to the previous question.
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  • 6
    If making public comment write "CONSTITUENT"
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  • 7
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  • 8
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  • 9
    Please Select
    • Please Select
    • Afghanistan
    • Albania
    • Algeria
    • American Samoa
    • Andorra
    • Angola
    • Anguilla
    • Antigua and Barbuda
    • Argentina
    • Armenia
    • Aruba
    • Australia
    • Austria
    • Azerbaijan
    • The Bahamas
    • Bahrain
    • Bangladesh
    • Barbados
    • Belarus
    • Belgium
    • Belize
    • Benin
    • Bermuda
    • Bhutan
    • Bolivia
    • Bosnia and Herzegovina
    • Botswana
    • Brazil
    • Brunei
    • Bulgaria
    • Burkina Faso
    • Burundi
    • Cambodia
    • Cameroon
    • Canada
    • Cape Verde
    • Cayman Islands
    • Central African Republic
    • Chad
    • Chile
    • China
    • Christmas Island
    • Cocos (Keeling) Islands
    • Colombia
    • Comoros
    • Congo
    • Cook Islands
    • Costa Rica
    • Cote d'Ivoire
    • Croatia
    • Cuba
    • Curaçao
    • Cyprus
    • Czech Republic
    • Democratic Republic of the Congo
    • Denmark
    • Djibouti
    • Dominica
    • Dominican Republic
    • Ecuador
    • Egypt
    • El Salvador
    • Equatorial Guinea
    • Eritrea
    • Estonia
    • Ethiopia
    • Falkland Islands
    • Faroe Islands
    • Fiji
    • Finland
    • France
    • French Polynesia
    • Gabon
    • The Gambia
    • Georgia
    • Germany
    • Ghana
    • Gibraltar
    • Greece
    • Greenland
    • Grenada
    • Guadeloupe
    • Guam
    • Guatemala
    • Guernsey
    • Guinea
    • Guinea-Bissau
    • Guyana
    • Haiti
    • Honduras
    • Hong Kong
    • Hungary
    • Iceland
    • India
    • Indonesia
    • Iran
    • Iraq
    • Ireland
    • Israel
    • Italy
    • Jamaica
    • Japan
    • Jersey
    • Jordan
    • Kazakhstan
    • Kenya
    • Kiribati
    • North Korea
    • South Korea
    • Kosovo
    • Kuwait
    • Kyrgyzstan
    • Laos
    • Latvia
    • Lebanon
    • Lesotho
    • Liberia
    • Libya
    • Liechtenstein
    • Lithuania
    • Luxembourg
    • Macau
    • Macedonia
    • Madagascar
    • Malawi
    • Malaysia
    • Maldives
    • Mali
    • Malta
    • Marshall Islands
    • Martinique
    • Mauritania
    • Mauritius
    • Mayotte
    • Mexico
    • Micronesia
    • Moldova
    • Monaco
    • Mongolia
    • Montenegro
    • Montserrat
    • Morocco
    • Mozambique
    • Myanmar
    • Nagorno-Karabakh
    • Namibia
    • Nauru
    • Nepal
    • Netherlands
    • Netherlands Antilles
    • New Caledonia
    • New Zealand
    • Nicaragua
    • Niger
    • Nigeria
    • Niue
    • Norfolk Island
    • Turkish Republic of Northern Cyprus
    • Northern Mariana
    • Norway
    • Oman
    • Pakistan
    • Palau
    • Palestine
    • Panama
    • Papua New Guinea
    • Paraguay
    • Peru
    • Philippines
    • Pitcairn Islands
    • Poland
    • Portugal
    • Puerto Rico
    • Qatar
    • Republic of the Congo
    • Romania
    • Russia
    • Rwanda
    • Saint Barthelemy
    • Saint Helena
    • Saint Kitts and Nevis
    • Saint Lucia
    • Saint Martin
    • Saint Pierre and Miquelon
    • Saint Vincent and the Grenadines
    • Samoa
    • San Marino
    • Sao Tome and Principe
    • Saudi Arabia
    • Senegal
    • Serbia
    • Seychelles
    • Sierra Leone
    • Singapore
    • Slovakia
    • Slovenia
    • Solomon Islands
    • Somalia
    • Somaliland
    • South Africa
    • South Ossetia
    • South Sudan
    • Spain
    • Sri Lanka
    • Sudan
    • Suriname
    • Svalbard
    • eSwatini
    • Sweden
    • Switzerland
    • Syria
    • Taiwan
    • Tajikistan
    • Tanzania
    • Thailand
    • Timor-Leste
    • Togo
    • Tokelau
    • Tonga
    • Transnistria Pridnestrovie
    • Trinidad and Tobago
    • Tristan da Cunha
    • Tunisia
    • Turkey
    • Turkmenistan
    • Turks and Caicos Islands
    • Tuvalu
    • Uganda
    • Ukraine
    • United Arab Emirates
    • United Kingdom
    • United States
    • Uruguay
    • Uzbekistan
    • Vanuatu
    • Vatican City
    • Venezuela
    • Vietnam
    • British Virgin Islands
    • Isle of Man
    • US Virgin Islands
    • Wallis and Futuna
    • Western Sahara
    • Yemen
    • Zambia
    • Zimbabwe
    • Other
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    Please be as specific as possible.
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    If "YES", the information must be emailed to Representative Shoaf's office at Jessica.Holley@myfloridahouse.gov by Friday, September 10, 2021 at 12PM EST.
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  • 12
    Drag and drop files here
    Select files to upload
    Max. file size: 10.6MB
    Cancelof
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  • 13
    A sentence or two describing the item for consideration. More background information (1-2 pages) can be sent via email to Jessica.Holley@myfloridahouse.gov.
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  • 14

    Thank you for your submission!
    (Be sure to click on the submit button below)

    REMEMBER:

    Information and handouts for those presenting must be emailed to Jessica Holley, District Executive Secretary of Intergovernmental Relations for Representative Shoaf at Jessica.Holley@myfloridahouse.gov 

    by Friday, September 10, 2021 at 12PM EST.

    Speakers will be limited to a maximum of three (3) minutes or less depending upon the number of speakers.

    Pursuant to Article 1, Section 24 of the Florida Constitution, this document and the information contained herein and any documents submitted for the Delegation Meeting, are public record.

    By submitting this form I understand that Florida has a very broad public records law and all information provided herein are public record.

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SPEAKER FORM - Legislative Community Forum hosted by Representative Jason Shoaf
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