Proclamation Request

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Proclamations in the Town of Leesburg, Virginia serve an important function in recognizing and celebrating causes or events that have a positive impact on the Town and its residents. Proclamations may recognize a certain event, day, week, or month.

The Town accepts proclamation requests from Council Members, residents, businesses, community organizations serving Leesburg and the greater Leesburg area, and staff for the Town Council’s consideration.

Please note the following requirements regarding the Town’s proclamation request process:

Requests must be submitted 30 days in advance of the date that the proclamation will be presented. No in-person, phone, mail, or email requests are accepted.
Recipient/s or designee/s must be in attendance during a Town Council meeting to accept a proclamation.
Submission requests are one-time requests and do not automatically renew.
Requestee must provide the proclamation language, which may be edited at staff or Council’s discretion.
A proclamation request does not guarantee that it will be approved by the Mayor and Council.
Proclamations for milestone birthdays start at 60 years old, in 5-year increments.
Proclamations for business milestone anniversaries start at 10 years, in 5-year increments.

Please complete the proclamation request form below. If approved by Council, staff will contact the requestee with additional details. Samples of past proclamations are available on the Council Documents & Legislation page under the Government/Mayor & Council tab.

Please correct the fields below:

Please correct the field(s) marked in red below:

1

Requestor Information

*

Requestor Information

Name

Organization/Business Name (if applicable)

Street Address

Zip Code

Phone Numberext.

Email

2

Event/Cause/Celebration

*

Event/Cause/Celebration

Proclamation Title (Ex: Bike to Work Day, National Drinking Water Week, Black History Month))

Specific Day, Week, or Month

Date Proclamation Needed By

3

Recipient(s)/Designee(s) to Receive Proclamation at Town Council Meeting (if different from requestor)

Name

Organization/Business Name (if applicable)

Street Address

Zip Code

Phone Numberext.

Email

4

Please provide no less than 5 bullet points (maximum of 500 total words) regarding the event/cause/celebration. Town staff may modify or amend submitted text as needed.

Samples of Previous Proclamations

*

Please provide no less than 5 bullet points (maximum of 500 total words) regarding the event/cause/celebration. Town staff may modify or amend submitted text as needed. Samples of Previous Proclamations

To receive a copy of your submission, please fill out your email address below and submit.
Email Address

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