Request for a Proclamation

2. Request a recognition for citizens, non-profit organizations, to honor occasions of importance and significance, and to increase public awareness on issues that improve the well being of the citizens of the city.

   Request a recognition for citizens, non-profit organizations, to honor occasions of importance and significance, and to increase public awareness on issues that improve the well being of the citizens of the city.

4. Requestor First Name*

5. Requestor Last Name*

7. Requestor Phone Number*

8. Requestor Email*

10. Organization*

12. Street Address*

14. City*

15. State*

16. Zip Code*

18. Name of Proclamation*

20. Date of Proclamation*

21. Date Proclamation is Needed*

23. Purpose(s) of the proclamation*

    Please describe the purpose(s) the proclamation is to serve, or the message that you would like to convey. Provide enough information to make 4 points.

25. Reissue Request from Previous Year(s)?*

    1. Yes
    2. No

26. Will you be submitting the proclamation to any publication(s)?*

    1. Yes
    2. No

28. Name of Publication(s)

30. Please briefly describe display/distribution plans for this proclamation*

32. Please note:

    Certificates or other forms of recognition may be considered for issuance when a proclamation is deemed to not be the appropriate form of recognition. Requests must be submitted fourteen (14) business days prior to the date needed.

    Certificates or other forms of recognition may be considered for issuance when a proclamation is deemed to not be the appropriate form of recognition. Requests must be submitted fourteen (14) business days prior to the date needed.

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33. 1. Receive an email copy of this form.
34. Email address

    This field is not part of the form submission.

35. Submit

* indicates a required field