COUNCIL RECOGNITION REQUEST FORM

COUNCIL RECOGNITION REQUEST FORM

Please use this form to request a recognition from the Mayor and/or City Council members for birthdays, anniversaries, or other special events.
BirthdayAnniversaryOther
Event Date:

MonthDayYear
Date
Please describe why this event is significant and provide any details that will help us prepare the recognition:
Who will be receiving or honored in the recognition:*

First NameLast Name
Mailing address for recognition:*

Address

Address Line 2

CityState

Zip Code
Today's Date:*

MonthDayYear
Date
Your Name:*
Your Phone Number:*
Format: (000) 000-0000.
Your Email Address:*
example@example.com
YESNOOther
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: