Document wqpvDgeZo3bvzwgzZbozoXBN4

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: Run of Show/ Agenda: Is there a Hold Room Available for the Administrator? Open Press/Closed Press? Dress Code: May 15, 2018 Marvin Childers, Pres. O f The Poultry Federation 59thAnnual Poultry Festival June 15-16, 2018 No Friday evening 6:30 - 10:00; Sat. 8:00am - 11:00pm Annual Festival Fri. Silent Auction; Sal: social and concert Annual Meeting o f the poultry industry Short speaking opportunity on Fri. evening or Sat. eevening The role o f EPA Open speaking opportunity without Q&A 15 mins. No Embassy Suites 3303 S Pinnacle Hills Parkway, Rogers, AR 72758 479-254-8400 Fri. evening 1500 people from the poultry industry; Sat. evening 2000 people from the poultry industry The Poultry Federation None Will be provided as soon as the agenda is completed Yes Open, however, we have never had much press coverage Casual/Business Page [PAGE] of [ NUMPAGES j Sierra Club v. EPA 18cv3472 NDCA Tier 1 ED 002061 00059928-00001 ADMINISTRATOR SCOTT PRUITT EVENT REQUEST FORM U.S. Environmental Protection Agency Teleprompter Available: No Microphone / Room Setup: Podium or lavalier; Round tables Honorable Guests Attending: Governor o fAR; AR Sec. o f Ag Notable Federal, State or Local Appointed or None Elected officials attending: _____ Individual Introducing Administrator: Marvin Childers, Pres. O f The Poultry Federation Person to contact for media purposes: Holly Rogers, 501-326-7715 Is this event held Weekly, Monthly, Annually? Annually Day of Event Point of Contact: Name & Title; Email; Office Number, Cell Number Security Contact: Name & Title; Email; Office Number, Cell Number Suggested Entrance/ Exit to Event Venue: Private entrance on back o fJohn Q Hammons Center Is the host of the event a registered 501(c)(3), (4), or has a 527 Political Action Committee (PAC): No 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 at ford. hayleyCfiepa. gov Sierra Club v. EPA 18cv3472 NDCA Tier 1 Page [PAGE] of l NUMPAGES j ED 002061 00059928-00002