Proclamation Request Submission

2. Name of Group/Organization/Individual*

3. Proclamation Date, Week or Month

5. Name of Proclamation*

   What is the occassion, event or person to be recognized? For example: Annual Red Cross Day, Severe Weather Awareness Week, John Smith Day, etc

7. Proclamation Text*

   Tell us about the occasion, event or special person being recognized with at least four main points.

9. Full Name*

10. Mailing Address

    Street Address, City, State, ZIP

12. Email*

13. Phone Number

15. Location of Presentation*
    -- Select One --Present at Council MeetingPickup at City HallMail to Address AbovePresent at Special Location

    How would you like this presented?

16. Date of Presentation*
    Date of Presentation

    When would you like this presented?

18. Address of Special Location for Presentation

Leave This Blank:


20. 1. Receive an email copy of this form.
21. Email address

    This field is not part of the form submission.

22. Submit Submit and Print

* indicates a required field