Proclamation Request Form Requester Name: * Requester Organization/Agency: * Is your organization/agency a state government agency? * Yes No Mailing Address (where the completed document should be mailed): Recipient * Organization (if applicable) Street Address 1 * Street Address 2 City * State * - Select -AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarshall IslandsMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Marianas IslandsOhioOklahomaOregonPalauPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirgin IslandsVirginiaWashingtonWest VirginiaWisconsinWyoming Zip Code * If the option is available, would you like to pick up the proclamation from the Administration Building (116 W. Jones St., Raleigh, NC) instead of having it mailed? * Yes No Requester Phone: * Please format as XXX-XXX-XXXX. Requester Email: * Would you like to receive a PDF of the proclamation? * Yes No Requested Title of Proclamation: * (Example: North Carolina Tar Heel Week) Requested Proclamation Date (MM/DD/YYYY): * (or date range if requesting week, month, or year) Suggested Text of Proclamation: * Please include all text for the proclamation below. Your draft should be 4-6 whereas clauses that show the importance and relevance of the proclamation to the people of North Carolina. Requests submitted without text will not be processed until a draft is provided. Find examples of proclamations. Sources * If you have not already, please use the space below to cite the sources for any statistics and/or information used in your suggested text. This will help us to verify this information. Is the proclamation to be presented at an event? * Yes No If you would like to invite the Governor or the Office of the Governor to attend or be involved in an event, please submit a Scheduling Request separate from this proclamation request. Additional Information (optional): Correspondence to and from this website may be subject to the North Carolina Public Records Law and may be disclosed to third parties by an authorized state official.
