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2. If you wish to schedule an appointment with Supervisor Burgis or invite her to an event,
   please complete the form below. Your information will be forwarded to Melissa van Ruiten. You can also contact Melissa van Ruiten directly at (925) 655-2330 or [email protected]

   Thank you for contacting the Office of County Supervisor Diane Burgis.
   
   
4. Name:*
6. Telephone:*
8. Email:*
10. Street Address:*
12. City:*
14. State:*
16. Reason for Appointment:*
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18. 1. Receive an email copy of this form.
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