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AD 18 Constituent Recognition Form
The Office of New York State Assemblywoman Taylor Darling proudly recognizes exemplary residents, students, groups and organizations, who are doing the necessary work to improve the quality of life in our District. The Assemblywoman wishes to honor those exemplary individuals and organizations with Certificates of Appreciation, Merit, Citations and the highest honor of a Proclamation. Please complete the form below, and a staffer will be in contact within 3-5 business days.

PLEASE NOTE: We STRONGLY discourage the submission of rushed requests. We are asking all entries to consider a 7-10 business day turnaround for requested recognition.
Email *
Email *
First Name
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Last Name
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Phone Number
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Address
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Address Line 2
Apt #
City
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State
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Zip
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Please type in the Bio for Nominee
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Number of awards requested
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Deadline (mm/dd/year)
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MM
/
DD
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YYYY
Time
:
Would you like Assemblywoman Darling to join ceremony or event?
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A copy of your responses will be emailed to .
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