Document GKEbbwQ58JLGN600GYavG1q2q
External Meeting Request Form Office of Water
U.S. Environmental Protection Agency
Thisform assists in planning participation in events and activities Please complete all requiredfields
This is not a confirmation of attendance.
Basic Background: Today's date
Requesting individual and/or affiliation
Name of Org/affiliation requesting to meet
Requested meeting date or date range Requested meeting time Location (e.g. EPA Headquarters) Virtual or In-Person
Meeting Description: Brief description or purpose of meeting: (e.g., meet and greet, policy discussion, informational) *Please attach a separate documentfar agenda/topics to be discussed[providefull context) List of attendees Officialfill name (per ID); Title; Email Address Please indicate International/Foreign visitors with country of residence (if any) Will there be time for Q&A? If so, who will be moderating
What questions will be asked?
Any PowerPoint presentations?
List names/title/email address/country of international/foreign attendees Attachments [please attach agenda and other meeting material(s)]. Agenda must be submitted together with the completed meeting requestform.
Ethics Considerations: Describe entity hosting EPA official
E.g., private company, political action committee, academic institution.
Sierra Club FOIA Request: 2025-EPA-04193
Rev. February, 2021 ED_018475D_00003411-00001
SC_FOIA_0001170
Has your organization ever received funding from EPA? If so, what type of funding did you receive for which project? Host(s) relationship to the EPA? Is the entity also a Federally Registered Lobbyist? Is there a registration fee? If so, does this fee apply to the speaker? Amount? Are you giving a gift, award, or anything else of value? What is the dollar value? Are you providing a meal? What is the dollar value?
Yes/No If applicable
If applicable
Contact Information: Your name and title: Telephone number: Mailing address:
E-Mail address: Cell phone number: Best way to reach you ?
EPA Contacts: Connie Eng, Special Assistant, OW/IO ([ HYPERLINK "mailto:eng.connie@epa.gov" ]) David Risley, Chief of Staff ([ HYPERLINK "mailto:risley.david@epa.gov" ]) Lynsey Lanier, Deputy Chief of Staff ([ HYPERLINK "mailto:lanier.lynsey@epa.gov" ])
Sierra Club FOIA Request: 2025-EPA-04193
Rev. February, 2021 ED_018475D_00003411-00002
SC_FOIA_0001171