| Ethics Commission, North Dakota

Name

Address

Address 2

City

State/Province

ZIP/Postal Code

Phone Number

Email Address

Are you a registered lobbyist?

Yes

Lobbyist Badge Number

Event Name

Event Start Date

Event End Date

Location

Type of Event

Private Social and Educational Event

Public Social and Educational Event

Educational Component of Event

Number of Total Projected Attendees

Number of Projected Attendees who are Public Officials*

Refer to the definition of “public official” contained in N.D.C.C. § 54-66-01(9) and N.D. Admin. Code § 115-03-01-01(8).

Number of Projected Attendees who are Registered Lobbyists

Total Estimated Cost of Event per Attendee

Description of Costs Associated with the Event (e.g. venue rental, educational materials, food/beverage)

Reminder: Food and beverage must be for immediate consumption ONLY.

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Additional Comments

Certification

I certify the information provided in this meeting notice is true, correct, complete, and of my own personal knowledge. I will fully cooperate in the process regarding this meeting notice.

Signature

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Meeting Notice