Request a Visit from the Food Safety Discovery Zone This form may be submitted by persons who wish to request a visit from the USDA Food Safety Discovery Zone. Submission of this form is NOT a guarantee of availability and does not commit USDA to attending the event. After you submit this form, a member of the FSIS Food Safety Education Staff will contact you for further information. Fields marked with an * are required. Email questions to firstname.lastname@example.org. Fields marked with * are required. Requestor Information Name* Organization* Title Address1 * Address2 City* State* Select a State AL-Alabama AK-Alaska AZ-Arizona AR-Arkansas CA-California CO-Colorado CT-Connecticut DC-District of Columbia DE-Delaware FL-Florida GA-Georgia HI-Hawaii ID-Idaho IL-Illinois IN-Indiana IA-Iowa KS-Kansas KY-Kentucky LA-Louisiana ME-Maine MD-Maryland MA-Massachusetts MI-Michigan MN-Minnesota MS-Mississippi MO-Missouri MT-Montana NE-Nebraska NV-Nevada NH-New Hampshire NJ-New Jersey NM-New Mexico NY-New York NC-North Carolina ND-North Dakota OH-Ohio OK-Oklahoma OR-Oregon PA-Pennsylvania RI-Rhode Island SC-South Carolina SD-South Dakota TN-Tennessee TX-Texas UT-Utah VT-Vermont VA-Virginia WA-Washington WV-West Virginia WI-Wisconsin WY-Wyoming Zip* Phone Number* Fax Number Email Address* Confirm Email Address* Event Information Start Date of Event End Date of Event Time of Event Name of Event Location of Event* Description of Event* How Did You Hear About the Food Safety Discovery Zone? Comments and Questions OMB Control Number. According to the Paperwork Reduction Act of 1995, an agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a valid OMB control number. The valid OMB control number for this information collection is 0583-0133. The time required to complete this information collection is estimated to average 5 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Thank you! Your submission has been sent successfully.