2. 
4. Request a Commemorative Message

   Mahalo for contacting the Office of the Mayor with your request.

   Required fields are marked with an asterisk (*) and MUST be filled in. Please note that we will be unable to process incomplete entries. 

   Types of Commemorative Messages

   The Mayor's Office offers recognition for significant events, accomplishments and milestones.

   • Proclamations recognize significant events for public awareness of a specific issue affecting Maui residents. (Note: The proclamation neither indicates nor implies the Mayor's support of any given issue or cause.)
   • Certificates recognize outstanding achievements by Maui residents. (We do not issue certificates for graduations or scholarships.)
   • Special messages mark significant occasions and public events in Maui, such as conventions, festivals and banquets.

   Guidelines for Commemorative Messages

   Due to the high volume of requests received daily, please observe the following guidelines.

   • All requests must be submitted at least four (4) weeks prior to the requested completion date and not more than three (3) months in advance of the event date.
   • All requests must be submitted by an individual or organization based in Maui, preferably submitted by an official representative of the local entity.
   • The Office of the Mayor reserves the right to accept or decline any request, regardless of whether a similar request was accommodated in previous years. We also reserve the right to edit submitted text for length, accuracy, etc.
   • All issued commemorative messages are to be used for a single event or recognition and are not to be used for profit or commercial advertising. The text of the issued document must not be altered in any way without the consent from the Office of the Mayor.
   • Organizations are limited to (1) one proclamation per calendar year.
8. Event Name*
10. Location of Event*
12. Event Date*
    Event Date

    Requests must be submitted at least four (4) weeks prior to the date it is needed, and not more than three (3) months in advance.

13. Commemorative Message Request*

    1. Proclamation
    2. Certificate
    3. Special Message
15. First Name*
16. Last Name*
18. Title
20. Organization*

    If you represent an organization, please include it here.

22. Organization Website
24. Your Addess*
26. Street Address
28. Address2
30. City*
31. State*
32. Zip*
34. Phone*
35. Alternate Phone
37. Email Address*
39. Requested Completion Date*
    Requested Completion Date
41. Delivery Method*

    1. Email
    2. Pick-up at the Office of the Mayor
    3. Mayor or his representative is requested to present proclamation at a special event
43. Email Address
45. 200 South High Street
    Kalana O Maui Bldg 9th Fl.
    Wailuku, HI  96793
    Ph: (808) 270-7855
47. scheduled for (date) and (time)
    scheduled for (date) and (time)

    scheduled for (date) and (time)
49. Who will the Proclamation be presented to*
50. How many people will be attending the event*
52. Please upload program (Timeline of Your Event)*
54. Requested Message*

    For Proclamation provide six statements.  For Certificate provide honoree's or name and details.

58. Is the event indoors or outdoors?

    1. Indoors
    2. Outdoors
59. Is this event open to the media?

    1. Yes
    2. No
60. Is this event open to the public?

    1. Yes
    2. No
62. Brief History/Background of the Organization:
64. Brief Description of Event:*
66. Speaking start time on the agenda?
    Speaking start time on the agenda?
67. Length of speaking time?
69. Attire?
71. Will there be other elected officials in attendance? If yes, who?*
75. 
79. Note:

    The Office of the Mayor reserves the right to accept or decline any request, regardless of whether a similar request was accommodated in previous years. We also reserve the right to edit submitted text for length, accuracy, etc. Completion of this form does not guarantee approval. 

Leave This Blank:


83. 1. Receive an email copy of this form.
84. Email address

    This field is not part of the form submission.

85. Submit

* indicates a required field