Document J6p2gg2Rd6pK18V9zv2eM572

ADMINISTRATOR SCOTT PRUITT EVENT REQUEST FORM U.S. Environmental Protection Agency Deadline for Acceptance: Requesting Individual/ Affiliation: Event Title: Event Date: Is the Above Date Flexible: Event Time & Duration: Type of Event: The event in March 1-3 2018 so the earlier we can confirm, the better The Club for Growth, Inc. Annual Economic Retreat March 1-3 2018 We can have him speak anytime that works for him. The retreat starts on Thursday evening, March 1 and goes through Saturday evening March 3 See above Conference Purpose of the Event: Role of the Administrator: Requested Presentation Topic, if Speaking Involved: Requested Presentation Format: Speech/Presentation Duration: Offthe record educational conference Keynote speaker Importance ofderegulation (or a topic ofhis choosing) Ke note 30 minutes plus question and answer portion (ifhe is willing to take questions) Would You Consider a Surrogate: Event Location: Event Audience: Event Host(s)/Organizer(s): Host(s)' Relationship to EPA: No, we would really like to have Administrator Pruitt The Breakers Hotel in Palm Beach, FL 150 ofthe Club for Growth's strongest supporters along with members ofthe House and Senate and academics. The Club for Growth, Inc. None 17cv01906 Sierra Club v. EPA Page 1 of 2 E D _001523B _ 00002413-00001 Is there a Hold Room Available for the Administrator? Open Press/Closed Press? Dress Code: Teleprompter Available: Microphone/ Room Setup: yes closed Business casual We can get one if he would like one) Theater style setup ifhe is speaking during the day, stage/podium ifhe is doing a keynote at lunch or dinner. We can have a lave microphone or handheld or both depending on what he prefers. Honorable Guests Attending: -T- ED- - - - - - - - - - - - - - - - - - - - - - - - Notable Federal, State or Local Appointed or TED Elected officials attending: Individual Introducing Administrator: David McIntosh, President ofThe Club for Growth Person to contact for media purposes: Rachael Slobodien: Rachae/(i1)c/ubforgrowth.org Is this event held Weekly, Monthly, Annually? Annually Day of Event Point of Contact: Virginia Galligan 646-499-1114 Security Contact: We will have security butfor now: Virginia Galligan (646) 499-1- 114- - - - - - - - - - - - - - - - - - - - - - - - Suggested Entrance/ Exit to Event Venue: Is the host of the event a registered 501(c)(3), (4), or has a 527 Political Action Committee (PAC): Will there be a "gift" presented to the Administrator? If so, what is the US currency value of the gift? Will a meal be provided, if so what is the US currency value? Hotel has a side entrance available 501 (c) 4 No TED depending on when he speaks Please return this form completed to scheduhng(ii1epa.gov and Aaron Dickerson at dickerson.aaron(a'1ez a.gov 17cv01906 Sierra Club v. EPA Page 2of 2 ED_001523B_00002413-00002