Proclamation Request Form

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Please correct the field(s) marked in red below:

1

Today's Date

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2

Date of proclamation start:

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3

Date of proclamation end:

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4

Proclaiming a (select one):

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5

What are you proclaiming?  (ex: Earth Week)

 *

Organization address:

6
Sponsoring Organization Name
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7

Street:

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8

City:

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9
State:
 *
10

Zip:

 *

Contact:

11

Name:

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12

Title:

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13

Phone:

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14

Email:

 *
15

Purpose of proclamation:

 *
16

Draft language of proclamation:

 *
17

Due to the nature of our community of four sister cities, organizations occasionally choose to do a joint proclamation.  Moorhead prepares these requests; however, the organization requesting the proclamation is responsible for contacting the other cities for approval, mayoral signatures, and seals.  Please select the city(ies) you want noted on your proclamation.

18

When was the last time you have requested a proclamation from the City of Moorhead?

 *
19

Notification preferences (select one):

 *
20
Event/Press Conference Date:
21
Event/Press Conference Time:
22
Would you like the Mayor to read your proclamation at the event?
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