Request a proclamation or certificate

Contact person name(Required)
First Last
This is the name of the person who is requesting the certificate or proclamation.
Contact person phone number(Required)
Contact person email address(Required)
Enter Email Confirm Email
Contact person mailing address(Required)
Street Address Address Line 2 City State ZIP Code

In case we need to contact you by mail, please provide your mailing address.
What organization are you a part of?
If you are making this request on behalf of an organization or business, please provide the full name of your organization/business.
Are you requesting a certificate of recognition or a proclamation?(Required)
- Certificate of recognition
- Proclamation
A certificate of recognition is a one-page certificate that recognizes an individual, group, or organization for their accomplishments and for contributing to improving Santa Ana. A proclamation is a long form that proclaims certain days, weeks, or months, such as Dr. Martin Luther King, Jr. Day or National Nurses Week.
When would you like to receive the certificate or proclamation?(Required)
Month
Day
Year

Indicate the date you would like to pick up, have mailed, or be presented with a certificate or proclamation.
Is there a specific councilmember that you would like to request the certificate or proclamation from?(Required)
Our certificates and proclamation are either prepared for or presented by a single councilmember or by the entire City Council.
Provide the name(s) of the individual(s) and/or organization that you would like the certificate or proclamation to be prepared for.(Required)
In 100 words or less, summarize why the individual(s) and/or organization should receive a certificate or proclamation from the City of Santa Ana.(Required)
If you are requesting a proclamation, please provide sample text for the proclamation.
If you have a sample or template for your certificate or proclamation, upload it.
Max. file size: 50 MB.
How would you like to receive your certificate or proclamation?(Required)
A certificate or proclamation can be mailed to you, you can pick it up at City Hall, or request to have it presented to you in person at a community event that you are hosting or at a City Council meeting.
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