Request for Proclamation

Please fill out this form to request a Proclamation from the Village of South Holland.

Name of person submitting this request*
First Last
What is the recognition for?*
Please give specific information regarding the person or event. Include significant and relevant historical information.*
Do you want the proclamation mailed? Or will it be picked up?*
- Please mail it
- It will be picked up
If mailed, please provide the full mailing address:
Street Address Address Line 2 City State ZIP Code
Phone Number:*
E-mail address:*
Enter Email Confirm Email