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2. POLICY:
   In accordance with Council's Rules of Procedure, a member of the public may request that a resolution be placed on a Council agenda to recognize an individual or group for something they did related to the MIddleburg community, including a particular service or achievement, or to recognize their life by submitting a request using this form and submitting it to the Town Clerk. Upon receipt, the Town Clerk shall forward it to the Mayor and Council to determine if a member wishes to sponsor it as an agenda item. Items that fail to receive a sponsorship shall not be placed on an agenda. Requests for resolutions shall not be considered for any item other than those identified above. A member of the public may request a proclamation (defined as an official formal announcement of an event or activity, or a formal recognition of a particular issue, cause or time period of awareness) by submitting a request using this form and submitting it to the Town Clerk. Upon receipt, the Town Clerk shall forward it to the Mayor for his/her consideration. While he/she may consult with the members of Council individually, the Mayor shall have the sole authority to decide whether to approve/issue a proclamation. Requests for proclamations shall not be placed on a Council agenda for consideration.
6. Applicant's Name:*
7. Organization (if applicable):
9. Telephone Number:*
10. Email Address:*
12. Physical Address*
16. TYPE OF RECOGNITION SOUGHT*

    1. Resolution recognizing an individual for something they did related to the Middleburg community, including a particular service or achievement, or to recognize their life
    2. Resolution recognizing an organization for something they did related to the Middleburg community, including a particular service or achievement
    3. Proclamation making an official formal announcement of an event or activity, or formal recognition of a particular issue, cause or time period of awareness
20. REASON FOR RESOLUTION/PROCLAMATION:*
    Please explain why you are asking the Town to issue a resolution or proclamation so the Mayor or Town Council may evaluate your request.
22. Please explain how this request is linked to the Town of Middleburg*
26. DESCRIPTION/VERBAGE FOR RESOLUTION OR PROCLAMATION*
    Please provide a sample resolution or proclamation or provide information as to what is expected to be contained within the resolution or proclamation
Leave This Blank:


28. 1. Receive an email copy of this form.
29. Email address

    This field is not part of the form submission.

30. Submit

* indicates a required field