Speaking Request

Name of Event*

Date of Event*

Time of Event*

Number of Attendees Expected*

Media Expected*

Organizer Name*

Organizer Phone Number*

Organizer Email Address*

Paid for by Bailey for Illinois. A copy of our report filed with the State Board of Elections is (or will be) available on the Board’s official website (www.elections.il.gov) or for purchase from the State Board of Elections, Springfield, Illinois.
Paid For By Bailey For Illinois • Bailey For Illinois • PO Box D • Louisville, IL 62858

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