Speaker's Greeting Request - Speaker Kevin McCarthy

Speaker's Greetings

Please fill out this form completely if you would like to receive a signed photo or letter from Speaker Kevin McCarthy.

What is the occasion?(Required)

What would you like to receive?(Required)

A personalized letter from Speaker McCarthy

A signed photo of Speaker McCarthy

Achievement Information

Achievement Type(Required)

What achievement would you like Speaker McCarthy to recognize?(Required)

Adoption information

Name(s) of the child/children adopted(Required)

Adoption date

Birth of a Child Information

Child's birth date

Birthday Information

How old is this person turning?

Eagle Scout / Girl Scout Gold Award - Information

Date earned

Graduation Information

Graduation Type(Required)

Graduation Date

New United States Citizen Information

Naturalization Ceremony Date

Retirement Information

Industry Worked In(Required)

Organization retiring from

Retirement date

Years of employment

Tell us about the recipient of this greeting

Who is being recognized and where should we send it?

Prefix

Primary Name(Required)

First Last

Secondary Name (if there is more than one recipient)

First Last

Suffix

Mailing Address(Required)

Street Address City State ZIP Code

Email Address

If we have follow-up questions, this is how we'll get in touch with you.

Would you like to receive once-a-month e-mail updates from the Office of Speaker McCarthy?

Yes

Additional information

Name

This field is for validation purposes and should be left unchanged.

Speaker’s Greeting Request