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2. Please read before submitting request:

   • Proclamation requests should be submitted via the form below.

   • Requests must be made at least 30 days in advance of date needed.

   • Please include no more than 6 whereas clauses. Any draft language submitted may be edited or revised without notice at the discretion of the City.

   • Proclamations should hold Waukee significance or relate to City of Waukee initiatives.

   • Issuance of a proclamation does not constitute an endorsement by the Mayor or the City of Waukee.

   • Proclamations are reviewed on a case-by-case basis and the City reserves the right to decline any request received.

   • Proclamations may or may not be read aloud by the Mayor.

6. Contact Information
8. First Name*
9. Last Name*
11. Organization Name
12. Email Address*
14. Address*
16. City*
17. State*
18. Zip Code*
20. Phone Number*
24. Date(s) of Proclamation*
26. Purpose of Proclamation*
28. Draft Language of Proclamation (Including 4-6 Whereas Clauses)*
30. Additional Comments/Feedback
Leave This Blank:


32. 1. Receive an email copy of this form.
33. Email address

    This field is not part of the form submission.

34. Submit

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