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Request a Proclamation

  1. Disclaimer
    Information submitted on this form will be sent via unsecured email. To protect sensitive information, do not enter the following items or similar information on this form: Social Security numbers, driver’s license numbers, bank account information, routing numbers, credit card numbers, medical information, passport numbers, and passwords. Please review our privacy policy located at By submitting this form, you acknowledge and accept the terms listed in the privacy policy.
  2. Please Answer the Following: *
    Which date span do you wish to proclaim? A date option will appear based on your selection.
  3. Please select the single date you request to proclaim.
  4. Please select the week-long period you wish to proclaim.
  5. Please select the month-long period you wish to proclaim.
  6. Please select the day you wish the proclamation to be issued and/or dated.
  7. Delivery Method*
    Please select the desired delivery of your requested proclamation.
  8. If attaching a file with the sample proclamation language, please type "N/A"
  9. Upload a draft copy of your proclamation
  10. Requested By:
  11. Leave This Blank:

  12. This field is not part of the form submission.