(Broward County Code of Ethics) Lobbyist Name: Email Address: Lobbyist Principal or Employer: Name of person or entity for whom/which you are lobbying: Name(s) of the Town Commissioner (s)/Employee (s) with whom you will be meeting/ contacting: Name(s) of your employer and/or principal to be present at a meeting/contact with a Town Commissioner at which lobbying activity is to occur: Type of scheduled meeting/contact: In person Email Phone Location of “in person” meeting: Date of scheduled meeting/contact: Time of meeting/contact: Description of the purpose and subject matter of the meeting/contact: Signed On This Day By: Lobbyist Acknowledgement of Receipt: Town Clerk: Date Leave this field blank
