COUNCIL RECOGNITION REQUEST FORM

COUNCIL RECOGNITION REQUEST FORM
Today's Date:*

MonthDayYear
Date
Your Name:*
Address:*

Physical Street Address

Street Address Line 2

CityState

Zip Code
Phone Number:*
Email Address:*
example@example.com
Requests must be submitted no less than 30-days in advance of the requested Voting Meeting date for presentation. Generally, Council meetings take place on the second and fourth Tuesday of each month at 3:00 p.m.
Meeting date requested*

MonthDayYear
Date
Name of person, organization, or event to be recognized*
Please provide a brief explanation for the recognition which should highlight an event, individual, milestone or any other significant occasion in the City of Prescott*
Signature*

Clear
Should be Empty: