Welcome! Please take a moment to answer the following questions. Certain information is required in order to process your message, other fields are optional, as indicated, but will expedite handling and provide useful information about your request.

If you would like to submit a recommendation for an appointment to a board or commission, please use the Appointment Recommendation Form. If you would prefer to submit a message to the Governor, please use the Message to the Governor Form. If you would like to submit a suggestion to improve government, please use the Suggestion to Improve Government Form.

Fields marked with an asterisk () indicate required information. If you have difficulty submitting the form, please contact our scheduling office at (405) 522-8806 for assistance.

 Request for: Click to Select Governor First Lady Representative Other

If you chose Other, please list with whom your request is for: 

 Request for: Click to select Speak Attend Photo Media Other

If you chose Other, please list what your request is for: 

 Date of Event:
January February March April May June July August September October November December 01 02 03 04 05 06 07 08 09 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 2009 2010 2011

 Sponsoring Group or Organization:


 Starting Time:
Hour 1 2 3 4 5 6 7 8 9 10 11 12 : Minute 00 05 10 15 20 25 30 35 40 45 50 55 AM/PM AM PM

Ending Time:
Hour 1 2 3 4 5 6 7 8 9 10 11 12 : Minute 00 05 10 15 20 25 30 35 40 45 50 55 AM/PM AM PM

Speech Time:
Hour 1 2 3 4 5 6 7 8 9 10 11 12 Minute 00 05 10 15 20 25 30 35 40 45 50 55 AM/PM AM PM

 Type of Event:


Event Overview: (Limited to 256 characters maximum)


RSVP Deadline: January February March April May June July August September October November December 01 02 03 04 05 06 07 08 09 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 2009 2010 2011
NOTE: Requests will be considered approximately thirty (30) days prior to the requested event date.

Speech Topic:


Event Location:
Street Address:

 City:

State: Zip Code: County: Select County Adair Alfalfa Atoka Beaver Beckham Blaine Bryan Caddo Canadian Carter Cherokee Choctaw Cimarron Cleveland Coal Comanche Cotton Craig Creek Custer Delaware Dewey Ellis Garfield Garvin Grady Grant Greer Harmon Harper Haskell Hughes Jackson Jefferson Johnston Kay Kingfisher Kiowa Latimer LeFlore Lincoln Logan Love Major Marshall Mayes McClain McCurtain McIntosh Murray Muskogee Noble Nowata Okfuskee Oklahoma Okmulgee Osage Ottawa Pawnee Payne Pittsburg Pontotoc Pottawatomie Pushmataha Roger Mills Rogers Seminole Sequoyah Stephens Texas Tillman Tulsa Wagoner Washington Washita Woods Woodward

Event Location Phone Number:
Area Code: Prefix Last Four

Directions to Event:


 Contact Person at Event:


Contact Person's at Event Cell Number:
Area Code: Prefix Last Four

Expected Number in Attendance:


Open to the Public:
Yes     No

Media Invited:
Yes     No

Photo Session:
Yes     No

Other Speakers (VIPs):
Yes     No

If you chose other, please specify below: 

Dress: Click to Select Business Attire Black Tie Business Casual Other

If you chose other, please list below: 

Event Emcee/Name of Person who will provide introduction:


Requestor Information

 Title: Click to Select Miss Ms Mrs Mr Dr Other

If you chose other, please list below: 

 First Name:


 Last Name:


Company/Agency Name:


 Mailing Address:
 Street (or P.O. Box):

 City:

 State:     Zip Code:

Requestor Phone Number:
 Area Code:  Prefix  Last Four

Requestor Fax Number:
Area Code: Prefix Last Four

Requestor Cell Number:
Area Code: Prefix Last Four

Please enter the confirmation key below.

The number for position 1 is: four plus four
The number for position 2 is: two plus one
The number for position 3 is: three plus two
The number for position 4 is: ten minus one
The number for position 5 is: seven minus two

*Enter Confirmation Key:

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Fields marked with an asterisk () indicate required information. If you have difficulty submitting the form, please contact our scheduling office at (405) 522-8806 for assistance.