City Commission Recognition Request
This form is to be used to submit all Coral Springs City Commission Recognition Requests. Please ensure the form is completed in it's entirety in order for your request to be given consideration.
Submission Date
-
Month
-
Day
Year
Date
Recognition Subject/Title
Recognition presentation (please select an option from the drop-down menu below)
Presentation during Commission Meeting
Presentation by Elected Official during a ceremony/event
Mail/Email
Please specify the time-frame for the Recognition:
Elected Official Name (if applicable)
First Name
Last Name
Department Director (if applicable)
Dale Pazdra - Director of Human Resources
Outside Organization Information
Please provide contact information of the point person at the Outside Organization.
Organization Name
Contact Person
First Name
Last Name
Phone Number
-
Area Code
Phone Number
Email
example@example.com
Recognition Request details
Please be very clear in your description of the request being made and the reason behind the request.
Type of Request (Please Select One)
Individual
Group
Outside Organization
School/Student/Teacher/Team
Other type of request:
How is the recognition connected to the Coral Springs community?
Please describe the reason for the recognition (1- 2 paragraphs)
Has this recognition been presented in prior years?
Yes
No
Unknown
(ELECTED OFFICIALS ONLY) If not, has the City Commission been polled to give consensus for the recognition?
Yes
No
Recognition Recipient details
Please provide contact information of the individual being recognized.
Name
First Name
Last Name
Phone Number
-
Area Code
Phone Number
Email
example@example.com
Address (for mail Recognition ONLY)
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Submit
Should be Empty: