Certificate/Proclamation Request Form
Instructions: Required fields are bold.

Step 1 of 2
Type of Request:
Brief Description of Event:
Person or Organization to be honored:
If more than one person, please specify others under "Brief Description of Event"
Date on Certificate or Proclamation:
yyyy/mm/dd		 Select Date
Contact Person:
Phone:
Phone2:
Email:
Projected Pick-up Date: 2013-05-29
Comments:
 

Pick-up Address:
Malana Joseph
City of New Orleans
Mayor's Office of Communication
1300 Perdido St., Suite 2E10
New Orleans, LA 70112
504-658-4900