2. Date Needed*
4. Proclamation Title*
6. Requestor Name*
8. Telephone*
10. Email*
12. Mailing Address*
14. City*
15. State*
16. Zip*
18. Affiliation to Organization*
20. Individual(s) Accepting the Proclamation*
22. Proclaiming*

    1. Day

    1. Week

    1. Month
24. Attach draft language*
26. Briefly describe your group, organization or cause*
28. Briefly describe the purpose(s) you would like a proclamation to serve, or the message that you would like to convey*
30. Please be advised that this application or information in this application may be subject to disclosure to other governmental agencies, or to the public pursuant to request under the Public Disclosure Act (RCW 42.56).
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32. 1. Receive an email copy of this form.
33. Email address

    This field is not part of the form submission.

34. Submit

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