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2. Please read the following information prior to submitting a proclamation request:

   • Proclamation requests must be submitted at least 30 days prior to the date requested.
   • Please include 4-6 whereas clauses. Please note any draft copy submitted is subject to revision without notice at the discretion of the City.
   • Proclamations should be significant to the City or relate to City of Ankeny initiatives or values.
   • Issuance of a proclamation does not represent an endorsement by the Mayor, City Council or City of Ankeny.
   • Proclamation requests will be reviewed on a case-by-case basis. The City reserves the right to decline any request received.
   • Proclamations may or may not be read aloud by the Mayor or a member of City Council.
4. Full Name*
6. Organization Name (if applicable)
8. Email Address*
10. Address*
12. City*
13. State*
14. Zip Code*
16. Date(s) of Proclamation*
    Date(s) of Proclamation
18. Purpose of Proclamation*
20. Draft language for Proclamation (including 4-6 whereas clauses)*
22. Additional Comments or Information
Leave This Blank:


24. 1. Receive an email copy of this form.
25. Email address

    This field is not part of the form submission.

26. Submit

* indicates a required field