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Proclamation Request Form

Section 1: Representative Contact Information

1. Full Name *This question is required.

2. Affiliation *This question is required.

3. Please name the Elected Position, County Department, or Organization with which you are affiliated *This question is required.

4. Email Address *This question is required. This question requires a valid email address.

5. Phone Number *This question is required.

6. Full Address *This question is required.

7. Will you and/or others attend the meeting during which the proclamation will be recognized? *This question is required.

8. If the answer above is YES, what is the number of attendees?

Section 2: Proclamation Details

9. Is the proclamation acknowledging a day, week or month? *This question is required.

Day
Week
Month

10. Please list the relevant date(s) *This question is required. (Example: month of February, April 3 – 7, September 8)

11. Please briefly describe how the proclamation relates to Arapahoe County services, employees and/or Strategic Plan *This question is required.

Section 3: Proclamation Text

Please provide Proclamation text. Complete at least three “whereas” statements and one “now, therefore be it proclaimed that…” statement.

12. Whereas #1 *This question is required.

13. Whereas #2 *This question is required.

14. Whereas #3 *This question is required.

15. Whereas #4 (Optional)

16. Now, therefore be it proclaimed that... *This question is required.

17. You may also upload proclamation text as a Word or PDF document.

File: {{filename}} delete

18. Would you like printed copies of the proclamation? *This question is required.

19. If the answer to the question above is YES, what is the quantity?

* Note that the Arapahoe County Commissioners will only issue up to two proclamations per business meeting. If approval of this request would exceed this limit for the requested business meeting date, it may be moved to a different date.