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2. First Name
3. Last Name
5. Address1
7. Address2
9. City
10. State
11. Zip
13. Email
14. Phone number
16. Purpose of Proclamation
18. Date Proclamation Needed
    Date Proclamation Needed
20. Please share a draft of your proclamation language (subject to editing by City Clerk's Office).
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22. 1. Receive an email copy of this form.
23. Email address

    This field is not part of the form submission.

24. Submit

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