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Proclamation Request

2. Date Proclamation is Needed:
   Date Proclamation is Needed:

4. Would you like a representative from the Executive Office to present the proclamation? If so, provide details of timing and nature of event and we will do our best to accommodate.

6. Person or Event to be Recognized:

8. Reason for Recognition:

10. Contact Person:

12. Organization:

14. Telephone Number:

16. Email:

18. Will you personally pick up the proclamation from the County Executive Office?

    1. Yes

    1. No

20. If not, please indicate below the address to which you would like the proclamation mailed:

22. In order to craft the proclamation, please sharerelevant details about the recipient's personal attributes and accomplishments.

Leave This Blank:


24. 1. Receive an email copy of this form.
25. Email address

    This field is not part of the form submission.

26. Submit

* indicates a required field