Xenia, OH

Proclamation Electronic Submittal

Date of Request*
Date of Request
Date Needed
Date Needed
at least 30 days from date of request
First Name*
Last Name*
Address1*
Address2
City*
State*
Zip*
Telephone Number*
Email Address*
If approved, how should the City of Xenia get the Proclamation to you?*
If the proclamation should be mailed to someone else, please provide the name and address of the recipient:
If you are requesting a proclamation presentation at your event, please provide the name of the event, date/time and location:
If you are requesting a proclamation presentation at a City Council meeting, please provide at least two upcoming Council meeting dates that would accommodate you.
The Council meeting dates you select should be after the 30-day period. The Council meets on the 2nd and 4th Thursday of each month at 6 p.m.
1st Date
1st Date
2nd Date
2nd Date
Please provide a brief summary and/or background of the event, organization, or individual:*
Please use this space to provide the exact wording in the Proclamation to include at least four "whereas" statements:
Name(s) and dates of the day, week, or month to be proclaimed:
Example: Thursday, May 30, 2019, proclaimed as John Doe Day in the City of Xenia or the month of May 2019 proclaimed as Motorcycle Awareness Month

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