Proclamation and Recognition Request Form

Please review the citizen recognition information on the Proclamations page before completing the form.

Requestor Information

Name of Requestor:*

First Name

Last Name

Phone Number:*

Email*

Type of Recognition: *

Name or Event Title:*

Enter the name or event title exactly as it is to appear on the certificate. Please double check the spelling.

Date to Appear on Certificate:*

Additional Information:

Presentation Information

Would you prefer to pick up the certificate? *

Yes No

Certificates may be picked up at the City Clerk's Office on the 2nd floor of City Hall, 301 W. 2nd Street. You will be notified when your certificate is ready.

Enter the mailing address to send the certificate to:

Address*

Address Line 1

Address Line 2

City

State

ZIP Code