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2. Please provide the following information:

4. Full Name of Organization or Individual Submitting Request*
6. Contact Email*
8. Contact Phone*
10. Date Proclamation or Citation is Needed*
12. Contact Mailing Address*
14. City*
15. State*
16. Zip Code*
18. Individuals / Organization to be Recognized*
20. Citations Only* Date of Birthdate / Anniversary / Retirement
22. Type of Request:

    1. Proclamation
    2. Citation
24. *Proclamations only:

    Proclamations must provide a draft whereas clauses: Sample Whereas Clauses: Whereas, arbor day first took place on April 10, 1872, in Nebraska and was the idea of Mr. Julius Sterling Morton, a Nebraska journalist and politician, and; whereas, more than one million trees were planted in Nebraska on the first arbor day; and; whereas, after the first arbor day, Morton's ideas spread beyond the borders of Nebraska into Kansas, Tennessee, Minnesota and Ohio. Today, all 50 states celebrate arbor day; please submit a draft whereas clauses in the space below:

26. *Citations only:

    Citations are generally issued for birthdays (over 80), anniversaries, retirements and outstanding service. Please identify the type of citation, provide the date of birth/anniversary/retirement and explain:

28. In 100 words or less please summarize why you are requesting a proclamation or citation:
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30. 1. Receive an email copy of this form.
31. Email address

    This field is not part of the form submission.

32. Submit

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