Athletic Citation Request

I’m happy to be able to honor, recognize and celebrate the milestones of individuals, organizations and teams who are in and/or serve my district, through awarding legislative citations.

My office accepts citation requests at all times, but please allow three to four weeks prior to an event for a request to be processed. If a citation is needed in two weeks or less, please give my office a call to ensure appropriate arrangements are made. While we do try our best, we cannot guarantee a citation will be available by a certain date. For any questions, please contact my office.

General Information

Full name of the Person, Team or Organization to be cited. *

Street Name *

City *

State *

Zip *

Phone Number (with Area Code) *

Presentation

How would you like the Representative to present this citation?

In Person In Private

Preferred Date *

Preferred Time *

Preferred Location *

Notes

Athletic Information

Sport *

Team or Organization Name *

Roster (if applicable)

School District and School Name (if applicable)

Specific Award or Accomplishment *

Contact Information

Full Name:* First Name:*

Last Name:*

Email Address: *Email: *

Phone Number: *Phone: *

Address: *

City: *

State: *

Zip Code: *

Additional Notes