Commendations and Greetings

Commendations and Greetings Form

Note: Fields marked with an * are required.

Prefix *

Ms. Miss. Mrs. Mr. Mr. and Mrs. Rev. Dr. The Honorable Rabbi

First Name *

Middle Initial

Last Name *

Suffix

2nd 3rd 4th II III IV Jr. Sr. M.D. PH.D. and Family

Street Address *

Street Address Continued

City *

State

AL AK AZ AR CA CO CT DE DC FL GA HI ID IN IL IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA RI SC SD TN TX UT VT VA WA WV WI WY

Zip Code *

Email *

Phone Number *

Phone Type *

Standard telephone device Videophone [VP] Text-telephone device [TTD]

What are these options?

Constituents who are hard of hearing or use a video phone have the option to choose TDD or VP based on the type of device they are using. This allows our office to respond to them accordingly. The default option "Voice" is a standard audible telephone.

First Name of Honoree *

Last Name of Honoree *

Street Address of Honoree *

Honoree's City *

Honoree's State

AL AK AZ AR CA CO CT DE DC FL GA HI ID IN IL IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA RI SC SD TN TX UT VT VA WA WV WI WY

Honoree's ZIP Code *

Exact Date of Occasion *

Recognition Type *

Appointment to public office Election to public office Awards or honors Citizenship Eagle Scout Gold Star Graduation Heroism Military academy appointment Other achievements of public distinction Presidential Greetings: Birthday (80 years) Presidential Greetings: Anniversary (50 years) Presidential Greetings: Wedding Presidential Greetings: Baby's Birth

Please provide other necessary information

Human Validation

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