State Capitol Lighting Request Form

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Request Information

Today's Date *

Request will take approximately ten (10) days to process.

Name of Event *

All requests shall reference an organization, State, or National event.

Preferred Date of Event *

Alternate Date of Event

Contact Information

Name of Organization *

Website Address

Website address is only needed if requestor would like to include hyperlink on OSB webpage.

Mailing Address *

Primary Contact Person Name *

Primary Contact Person Job Title

Primary Contact Phone Number *

Primary Contact Alternate Phone Number

Primary Contact Email Address *

Alternate Contact Person *

Yes

Color Selection

Event Justification

Description of Event and Purpose in Detail *

Requestor

Requestor Name *