City of Newport News Retirement Award Ordering Form
Congratulations on your recent retirement. We truly have valued the years you dedicated to the City of Newport News. As a thank you for your years of service with the City , we invite you to order a retirement gift from our catalog of available items.
Name
*
First Name
Last Name
Personal Email
*
example@example.com
Best Phone Number to reach you
*
Please enter a valid phone number.
Format: (000) 000-0000.
Department you are retiring from
*
Retirement Effective Date
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Years of Service
*
How would you like to recieve your gift catalog?
*
Mail me a paper catalog
Email me a link to order my gift online
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Submit
Should be Empty: