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2. Name of Organization or Person Making Request*
4. Requested Title of Proclamation*

   Examples include "Joseph Smith Jr Day" or "Hands-Only CPR Day" or "Be a Mentor Week"

6. Proclamation Requested for Which Date*

   Request can be a specific day (i.e. Monday, June 24, 2024) or week (i.e. Week of June 24-28, 2024) or month (i.e. Month of June, 2024)

8. Draft Language for Proclamation*

   Include 2 to 4 'whereas' statements to make up the body of the proclamation. The Mayor's Office reserves the right to edit proclamation language.

10. Contact Name*
11. Contact Phone Number*
13. Contact Email
15. Information Consent*

    1. I consent to the City of Bluffton, Indiana storing my submitted information so they can respond to my inquiry.
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17. 1. Receive an email copy of this form.
18. Email address

    This field is not part of the form submission.

19. Submit

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