Request General Citation

MEET MELISSA
NEWS
MY LEGISLATIVE AGENDA
CONSTITUENT SERVICES
CONTACT

Melissa Agard, Wisconsin State Senate, District 16
CONSTITUENT SERVICES
REQUEST A LEGISLATIVE CITATION
Request General Citation

Request a General Citation

Legislative citations are an opportunity for me to honor constituents in my district for their work in a variety of different capacities. Please fill out this form to request a legislative citation for yourself or someone else in our community who deserves recognition. Please provide as much detail as possible in order to help me honor the citation recipient.

Citation Requester's Information

First Name: *

Last Name: *

E-mail: *

Phone Number *

Home Address (Street, City, Zip) *

Citation Information

Date by which you need the citation *

How would you like the citation delivered? *

Mail
In-Person Presentation by Senator Agard

If you selected in-person delivery, please describe the date, time, location, and any other information about when the citation should be delivered.

If you selected mail, please provide the address you would like the citation sent to.

Information about Citation Recipient

Name as you would like it displayed on citation *

Phone Number *

Email Address *

Constituent's Home Address (Street, City, Zipcode)

Reason Citation is Being Requested *

Accomplishment
Anniversary
Award Recipient
Birthday
Career Milestone
Community Service
Graduation
Honor Flight
Retirement
Other

Please describe in further detail the act or honor being cited, any important anecdotes of note, or anything else you would like Senator Agard to include in the citation. *

Brief Recipient Bio

Date of Ceremony *

State Capitol P.O. Box 7882, Madison, WI 53707
(608) 266-9170
Sen.Agard@legis.wisconsin.gov