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Schedule Request Form

  1. NOTE: To submit this form you do not have to sign in or create a Jackson County Form Center account above. However, you will have to complete the form in its entirety without the option to save your progress unless you do create an account.


    Thank you for requesting a meeting with the County Executive or for the County Executive' attendance at your event. We do all we can to fulfill as many requests as possible. Please understand, however, that we will receive hundreds of requests each year, so it is simply impossible to say "yes" to each and every one.

    We ask that requests be submitted at least THREE WEEKS prior to an event. We will send you a respond not later than TWO WEEKS before the event.

  3. Contact Information

  4. What is the nature of this request?*

  5. Be Specific

  6. PDF files accepted

  7. Will the County Executive be asked to speak at this event / meeting?*

  8. Point Of Contact For The Request (POC)

  9. Leave This Blank:

  10. This field is not part of the form submission.