To request a meeting with Rep. DeGette, please fill out the following form. Due to the Member's schedule, not all requests will be filled. Note: * marks required fields of data. Activity Details Location of Event: * - Select -In DistrictIn Washington, DC Number of Attendees: * Subject: * Details: * Date Available (From): * Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Day Day12345678910111213141516171819202122232425262728293031 Year Year20182019202020212022 Date Available (To): * Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Day Day12345678910111213141516171819202122232425262728293031 Year Year20182019202020212022 Phone Number * Phone Type: Standard voice telephoneVideophone [VP]Text-telephone device [TTD] Point of Contact Phone Number: * (To be used for the day of the appointment) Phone Type: Standard voice telephoneVideophone [VP]Text-telephone device [TTD] What are these options? Constituents who are hard of hearing or use a video phone have the option to choose TDD or VP based on the type of device they are using. This allows our office to respond to them accordingly. The default option "Voice" is a standard audible telephone. Your Information Prefix: * First Name: * MI: Last Name: * Suffix: - None -2nd3rd4thIIIIIIVJr.Sr.M.D.PH.D.and Family Organization: (please spell out acronyms) * Street Address: * Street Address Continued: City: * State: * Zip Code: * Email: * CAPTCHAThis question is for testing whether or not you are a human visitor and to prevent automated spam submissions.
