Document 3ND0BK6LyV2O9n2orjxj9B6mJ

ADMINISTRATOR PRUITT SPEAKER REQUEST FORM U.S. Environmental Protection Agency Deadline for Acceptance: [Publication or otherwise; please see details below] Event Title: [American Principles Project- Red, White and Blue Gala] Speech Date: Is the Above Date Flexible: [Wednesday, November 29, 2017] [No] Speech Time & Duration: [8:30pm-8:50pm] Speaker Requested: Administrator Scott Pruitt Would You Consider a Surrogate: [No] Event Location: [Mayflower Hotel] 1127 Connecticut Ave NW, Washington, DC 20036 (202) 347-3000 Open Press/Closed Press: Is Event Webcast/Recorded/Transcribed: Purpose of the Event: Speech Topic: Requested Presentation Format: Dress Code: Speech/Presentation Duration: Teleprompter Available: Microphone / Room Setup: Event Sponsor: Relationship to the EPA: Event Agenda/Program: [Open] [Yes- recorded] [This annual gala is APP's major fundraising event. The goal is to bring together top donors and supporters and highlight the work have they done over the past year. ] [Topic- TBD] [Keynote] [Business] [20 minutes] [Yes] [Podium mic. The room will be set in banquet rounds] [List all Sponsors- TBD] [Enter Here] 6:30pm- Cocktail reception 7:30pm- Dinner starts 7:35pm- MC welcomes 7:45pm- President Remarks 8:00pm- Break for dinner 8:30pm- Keynote address by Administrator Pruitt Honorable Guests Attending: TBD Notable Federal, State or Local TBD Page 1 of 2 17cv1906 Sierra Club v. EPA ED_001523B_00005386-00001 ADMINISTRATOR PRUITT SPEAKER REQUEST FORM U.S. Environmental Protection Agency Appointed or Elected officials attending: ___________________________________ Individual Introducing Administrator: TBD Person to contact for speechwriting purposes: Terry Schilling Executive Director tschilling@americanprinciplesproj ect.org 309-230-3909 Person to contact for media purposes: Jon Schweppe Director of Communications jschweppe@americanprinciplesproiect.org 309-749-7009 Origin of Invitation: Day of Event Point of Contact: Terry Schilling Executive Director tschilling@americanprinciplesproj ect.org 309-230-3909 Allegra Hewell Owner- Hewell Events Group Allegra@hewellevents.com 7041^ Security Contact: Allegra Hewell Owner- Hewell Events Group Allegra@hewellevents.com 70-927-2473 Is the organization or host of the event a registered 501(c)(3), (4), or has a 527 Political Action Committee (PAC): ______ 501c3_______________________________________________________ Will there be a presentation of a "gift" to the Administrator? ______ No________________________________________________________ If so, what is the US currency value of the gift? _______________________________________________________ Will a meal be provided, if so what is the US If he as able to stay for dinner then the value is roughly $75 currency value? Please return this form completed to scheduling@epa.gov and Sydney Hupp (hupp.sydney@epa.gov). Page 2 of 2 17cv1906 Sierra Club v. EPA ED_001523B_00005386-00002