Scheduling Requests

To request Senator Kane’s participation in an event or to schedule a meeting with the Senator, please complete the following form below to submit your request.

Scheduling Requests

Contact Information

First Name *

Last Name *

Organization

Address *

Address 2

City *

State *

Zip Code *

Email *

Phone Number *

Cell Phone Number

Event Information

Reason for Meeting/Event *

Meeting/Event Description *

Meeting/Event Date *

Time Frame - Begin

Time Frame - End

Additional Information