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  • Request for Supervisor Grijalva attend a community event or function

    Fill out the form below to assist the Supervisor’s staff in coordinating his attendance or participation at your event. Send any attachments separately to D5scheduling@pima.gov.
    Event Request Form

    Contact Information

    Name of requester: *  

    Organization: *  

    Business Phone: *    Mobile Phone: *  

    Email: *  

    Event Information

    Name of Event: *  

    Event date (MM/DD/YY): *  

    Type of Event: *  

    Location Address: *  

    Event Start time: *    Event End time: *  

    Role of Supervisor Villegas: *
    Speaker - welcome remarks (3-5 minutes)
    Speaker - brief remarks (less than 15 minutes)
    Speaker - keynote address (15 minutes or more)
    Panel participant
    Attendee only
    Other (please specify below)

    Purpose of Supervisor's participation: *

    Number of guests expected?: *  

    A list of other dignitaries, special guests, and elected officials on the event program: *

    The name & title of the person introducing the Supervisor, if applicable:   

    Any supporting electronic flyer, graphic, or invitation summarizing the event send separately to D5scheduling@pima.gov.


    Referred from Page: 

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    Supervisor Adelita Grijalva, Vice Chair

    Pima County, Arizona
    District 5

    33 N. Stone Ave., 11th Floor
    Tucson, AZ 85701

    Phone: (520) 724-8126
    Fax: (520) 884-1152
    E-Mail: District5@pima.gov

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