APPLICATION FOR A PADUCAH, KENTUCKY
DUKE/DUCHESS AWARD
Applications must be returned at least 10 days prior for Mayor approval and issuance of
award to: General Government, City Hall, P.O. Box 2267, Paducah, KY 42002-2267 or
Fax: 443-5058. Please print clearly. Thank you!
Name of person to receive award: ___________________________________________________
Address: ______________________________________________________________________
(Include Street Address, City, State, and Zip Code)
Date on Award: ________________________________________________________________
Business or professional organizations of which applicant is a member:
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
Why do you feel this person should receive a Duke/Duchess Award?)
(Examples: Contributions to community, charity or church work, acts of bravery, etc.)
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
Name of person making request: ___________________________________________________
Address: ______________________________________________________________________
Phone: ___________________________ Date: _____________________
Will you pick up award (s) at the Mayor’s Office? (Check One) Yes___ No___
If no, send to: Name: __________________________________________
Address: _________________________________________________________
*Internal Use Only
Received: _______________________ Mayor Sign-Off: ____________
Computer Indexed: ____________________
