Document mBG0ZVeg3NaYE1novE9Zeg8nQ

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: Purpose of the Event: Role of the Administrator: Requested Presentation Topic, if Speaking Involved: Requested Presentation Format: Speech/Presentation Duration: Would You Consider a Surrogate: Event Location: Event Audience: Event Host(s)/Organizer(s): Host(s)' Relationship to EPA: End ofDecember The Aspen Institute Aspen Institute's Washington Ideas Roundtable Series Flexible - February 5-9, 12, or 20-22 Yes Noon- I: 30 pm ~ 90 minutes Roundtable Discussion We propose that you deliver brief remarks and then our moderator would ask you a few questions before opening up the table to comments and questions with about 25-30 professionals from business, academia and non-profit organizations. Speaker and participant in discussion The environment Keynote followed by discussion 10 minute keynote (flexible) followed by roundtable discussion no Aspen Institute 2300NStNW Washington DC 25 senior members ofthe energy and environment community The Aspen Institute NIA 17cv01906 Sierra Club v. EPA Page 1 of 2 ED_001523B_00001555-00001 Is there a Hold Room Available for the Yes Administrator? Open Press/Closed Press? Flexible -can be on the record or not for attribution Dress Code: Business Teleprompter Available: Microphone/ Room Setup: Round table setup. Table top microphones Honorable Guests Attending: NIA Notable Federal, State or Local Appointed or NIA Elected officials attending: Individual Introducing Administrator: David Monsma, Vice President, Executive Director Person to contact for media purposes: Greg Gershuny, Grcg.Gcrshuny@aspeninst.org 202-736-3576 Is this event held Weekly, Monthly, Annually? Monthly Day of Event Point of Contact: Greg Gershuny, Greg.Gcrshuny@1laspeninst.org 202-736-3576 Security Contact: Suggested Entrance/ Exit to Event Venue: Greg Gershuny, Grcg.Gcrshuny@aspeninst.org 202-736-3576 24th and N st Is the host of the event a registered 501(c)(3), (4), or has a 527 Political Action Committee (PAC): 50] C 3 Will there be a "gift" presented to the Administrator? If so, what is the US currency value of the gift? No Will a meal be provided, if so what is the US currency value? No Please return this completedform to Hayley Ford 17cv01906 Sierra Club v. EPA Page 2of 2 ED_001523B_0000 1555-00002