Proclamation Request

Prefix:*
Name*
First Last
Email Address*
Address*
Street Address City State / Province / Region ZIP / Postal Code
Contact Phone #*
Title of Event/Occasion*
Date of Event/Occasion*
MM slash DD slash YYYY
Are you requesting a formal proclamation ceremony?*
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- No
Group or Organization in the Proclamation*
Reason for Proclamation*
Sample Text for Proclamation*
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Kansas great seal

CONTACT

Statehouse Address
300 S.W. 10th Ave.
Topeka, KS 66612
785-368-8500