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Proclamation Request Form

2. Today's Date
   Today's Date

4. First Name*

5. Last Name*

7. Phone Number*

8. Email Address*

10. Address

12. City

13. State

14. Zip Code

16. Type of Recognition*
    -- Select One --Certificate of AppreciationCertificate of CongratulationsCommunity Service AwardDistinguished Service AwardProclamation

18. Name or Event Title as it should appear on the Proclamation*

    (i.e. Fire Safety Month, Spay-Neuter Awareness Week, etc.)

20. Date to Appear on the Proclamation*
    Date to Appear on the Proclamation

21. What is the Deadline for this Proclamation?
    What is the Deadline for this Proclamation?

    (Requests must be made three weeks prior to this date)

23. Please provide as much information as you can to complete the Proclamation*

25. Attach any additional resources (if applicable)

    Item 1

26. Attach any additional resources (if applicable)

    Item 2

28. Where would you like the Proclamation presented?*
    -- Select One --At a City Council MeetingAt an EventNo Presentation, just pickup from the City Secretary

30. At which meeting would you prefer the proclamation to be presented?*
    At which meeting would you prefer the proclamation to be presented?

    City Council meetings are on the Second and Fourth Thursdays of the month in January - September, and the First and Third Thursdays of the month in October - December. The first meeting of the month is at 8:30 a.m., and the second meeting of the month is at 5:30 p.m.

32. Please add all event information, including date, time, and location.*

34. Please list the name and phone number of the person who will be picking up the proclamation.*

Leave This Blank:


36. 1. Receive an email copy of this form.
37. Email address

    This field is not part of the form submission.

38. Submit

* indicates a required field