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2. Name of Request Organization*
4. First Name*
5. Last Name*
7. Phone Number*
8. Fax Number
10. Email Address*
12. Address
14. City
15. State
16. Zip Code
18. Individuals or Organization being Recognized*
20. Please Select the Primary Reason for Issuance*

    1. Significant Matter of Interest
    2. Observance/Celebration
    3. Local Business, Service, or Organization
    4. Individuals
    5. Local Sports Team
    6. In Memoriam
    7. City Officials/Staff
    8. Partner Public Official
22. Please Specify the Period of Time for the Observation*

    1. Day
    2. Week
    3. Month
    4. Not Applicable
24. Please Summarize the Reason(s) for Requesting a Proclamation*
26. Please Provide Sample Language for the Proclamation*
28. Preferred Method of Delivery:*

    1. Mail
    2. Pickup
    3. Council Meeting
30. For Longer Sample Text, Please Upload a Microsoft Word or PDF Document
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32. 1. Receive an email copy of this form.
33. Email address

    This field is not part of the form submission.

34. Submit

* indicates a required field