Proclamation/Certificate Request Form

Proclamation/Certificate Request Form
The City of West Hollywood proudly issues Proclamations and Certificates of Recognition or Commendations to honor individuals and organizations that have made meaningful contributions to the community. Recognitions are strictly honorary and are issued as a courtesy to celebrate achievements and milestones that align with the City’s values.

Certificates of Recognition or Commendation - these celebrate:
- Significant personal or professional milestones.
- Individual contributions to society.
- Community events or achievements.
- Statements of congratulations.
Proclamations - these are ceremonial documents to:
- Commemorate community or organizational milestones.
- Celebrate events of historic or unique importance to West Hollywood.
- Recognize the work of individuals or organizations.
- Acknowledge extraordinary achievements or significant commemorative dates.
When submitting a request below, please keep the following in mind:
- Requests promoting political campaigns, events, or ideological beliefs contrary to the policies or positions of the City of West Hollywood will not be considered.
- Requests must be submitted at least two weeks before the preferred pick-up or delivery date.
- Recognitions are generally issued only for individuals, events, or organizations with a direct tie to the West Hollywood community.
- The City reserves the right to modify, edit, or deny any request in accordance with its recognition policy.
- For questions or concerns regarding this form, please contact Justin Tindall, Community Affairs Supervisor, at jtindall@weho.org.
Your Information

Please provide your information as the requestor below.
Full name:

First NameLast Name
Organization (Optional):
Title (Optional):
E-mail:
Phone:
What are you requesting?
Select one.
About the Community Member or Organization

Please provide information about the person or organization you wish to recognize below.
Name of community member or organization to be recognized:
Please write the full name as you would like it to appear on the proclamation or certificate.
Briefly describe the reason for this recognition request:
Please include a description of the community member or organization's ties to the City of West Hollywood.
Date to commemorate:

MonthDayYear
2 digit month, 2 digit day, 4 digit yearPlease provide the date you'd like to appear on the proclamation or certificate.
Draft text for the proclamation or certificate:
If you are requesting a Proclamation, please include four to six “Whereas” statements. If you are requesting a Certificate, please include two lines of text for placement on the certificate.
File upload (optional):

Please provide any supporting documents to help with this request.
Cancelof
Pick-Up/Delivery Options

Please select preferred method below.
How would you like to receive the proclamation or certificate?
If applicable, please provide details about the presentation event (including City Council Meetings):
Please provide as much information as possible, especially if you're requesting the Mayor, Vice Mayor, or Councilmembers to present the proclamation or certificate at an event. While we cannot guarantee their attendance or participation, we will make sure they receive the invitation.
If applicable, address for delivery:

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Preferred date for pick-up or delivery:

MonthDayYear
2 digit month, 2 digit day, 4 digit yearReminder: requests must be submitted at least two weeks before your preferred pick-up or delivery date.
Should be Empty:

Proclamation/Certificate Request Form

Your Information

About the Community Member or Organization

Pick-Up/Delivery Options