Request a Proclamation

Salutation

Requestor Full Name *

Requestor Email Address *

Requestor Phone Number *

Organization you are representing *

Organization's Website

Organization's mission statement *0 / 500

Role in organization *

Street Address *

Apartment, suite, etc

City *

State/Province *

ZIP / Postal Code

Date Proclamation is needed *

Please allow 4-6 weeks for review

Date Type *DayWeekMonthPick day, week, or month

Date of Proclamation (Day) *

mm/dd/yyyy. Please allow 4-6 weeks for review.

Start Date (Week) *

Enter start date of proclamation week

End Date (Week) *

Enter end date of proclamation week

Month for Proclamation *

Year for Proclamation (Month) *

Title of Proclamation *0 / 30

Proposed language for proclamation *Please provide four to six WHEREAS clauses.

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