Fillable Citation Proclamation Request Form (City of Fitchburg)

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Citation Proclamation Request Form (City of Fitchburg)

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Citation / Proclamation Request Form
Contact Information:
Name:_____________________________________________________
Phone: ____________________________________________________
Address: __________________________________________________
Email: ____________________________________________________
Event Details:
Title of Event: ______________________________________________
Location:___________________________________________________
Date: ________________________________
Time: ________________________________
Citation Details:
Recipient (Name or Business): __________________________________________
Type of Event (Retirement, Birthday, Scouting, ect.):_________________________
Event Details: _______________________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
Please save as a document and email to atourigny@fitchburgma.gov and jdavid@fitchburgma.gov or mail to:
Office of the Mayor
166 Boulder Drive
Fitchburg, MA 01420
The City of Fitchburg
Massachusetts
OFFICE OF THE MAYOR
STEPHEN L. DINATALE
MAYOR
166 BOULDER DRIVE
FITCHBURG, MA 01420
TEL. (978) 829-1801
AARON TOURIGNY
CHIEF OF STAFF
JOAN DAVID
ATOURIGNY@FITCHBURGMA.GOV
JDAVID@FITCHBURGMA.GOV
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Citation Proclamation Request Form (City of Fitchburg)

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Completed 3 August 2020

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