Recognition Request Form

Utility Payment

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Name:: *

Address:: *

Apt/Ste #::

City:: *

Zip:: *

Phone Number:: *

Pick One: *

(Congratulations, Commendations, Appreciation, Recognition, etc)

What is this recognition for?: *

When will this recognition be presented?: *

If at a City Council Meeting, please specify the meeting?

Please briefly describe yourself, group, organization or cause:: *

Please provide at least four "whereas" statements, to describe the purpose of this proclamation or other recognition: *

Examples:

WHEREAS, Girl Scouts throughout the nation have rendered continuous service to their
communities and their country since the founding of their organization on March 12, 1912, by Juliette
Gordon Low, in Savannah, Georgia; and
WHEREAS, we are aware of the tremendous growth of the Girl Scout movement, which has
become the largest organization for girls in the free world; and
WHEREAS, Girl Scouts of America, through its continuous program for girls ages seven to
seventeen, provides its members with a bridge to the future by developing good citizenship through
teaching important skills, encouraging career exploration, and increasing world understanding; and
WHEREAS, all Girl Scouts make a solemn promise to do that duty to God and country, to help
others at all times, and to obey the Girl Scout laws;
NOW, THEREFORE, I do hereby proclaim (dates) as GIRL SCOUT WEEK and call upon all citizens
to give this organization their continued support, interest, and cooperation in its purpose of inspiring

Would you like to invite the Mayor or City Official to present the recognition?: *