Citation Request Form
Legislative citations are an opportunity for me to honor constituents in my district for their work in a variety of different capacities. Please fill out this form to request a legislative citation for yourself or someone else in our community who deserves recognition. Please provide as much detail as possible in order to help me honor the citation recipient. Please note that citations requested to be mailed will be sent to the person requesting the citation or delivered to the person requesting the citation.
Citation Requester's Information
First Name *
Your answer
Last Name *
Your answer
Phone Number *
Your answer
Email Address *
Your answer
Address
Requester's Street Number and Name *
Your answer
Apartment, suite, etc. (if applicable)
Your answer
City *
Your answer
State *
Your answer
Zipcode *
Your answer
Citation Information
Date by which you need the citation *
MM
/
DD
/
YYYY
How would you like the citation delivered? *
If you selected in-person delivery, please describe the date, time, location, and any other information about when the citation should be delivered.
Your answer
Which type of citation are you requesting? *
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