District Meeting Request

Please fill out this form as appropriate to ensure that the Congressman has all the necessary information regarding your meeting. His scheduling team will be in touch with you soon.

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Your Information

prefix:

First Name:

Last Name:

Suffix:

Street Address:

Street Address Continued:

City:

State:

ZIP Code:

Email:

Phone Number:

Meeting Details

Location of Meeting:

Other Location:

Contact Person Day of Meeting and Phone No.:

Organization:

Topic of meeting:

Date of Meeting:

Timeframe:

Number of Attendees:

Name of Attendees and Hometown:

Description of Meeting:

Additional Comments or Concerns:

CONGRESSMAN JIM HIMES

Representing the 4th District of Connecticut

District Meeting Request

Office Locations

Bridgeport, CT

Stamford, CT

Washington, D.C.

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District Meeting Request

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Bridgeport, CT

Stamford, CT

Washington, D.C.