Constituent Services Request Webform

Please provide complete contact information and all requested details regarding recipient of the recognition and delivery details if our office is able to fulfill the request.

Please complete all required fields (* indicates a required field)

Salutation:
* First Name:
* Last Name:
* Address:
* City:
* State:
* Zip:
* Phone:
* Email:
* Date Needed:
* Type of Request:

* Recipient's Full Name:
* Recipient's Address:
* Recipient's City:
* Recipient's State:
* Recipient's Zip:
* Occasion:
* Mail recognition to:
* Type of Recognition:

* Type of Flag:
* Date flag is to be flown:
* Recipient’s Full Name:
* Recipient’s Address:
* Recipient’s City:
* Recipient's State:
* Recipient’s Zip:
* Mail recognition to:

* Proclamation Title:

NOTE: Proclamation requests are reviewed 4-6 weeks ahead of the requested issue date. Short notice requests may not be honored. To be fully considered, proclamations must be requested or supported by an Alaskan, and must include proposed draft language. Final approval and content of any proclamation is at the sole discretion of the Office of the Governor. Approved proclamations will not specifically advertise or endorse a specific organization, event, business, living individual, product, or service.

NOTE: The Office of the Governor provides special recognitions by request to current and former Alaskans. Requests must be made at least two weeks in advance and meet certain criteria. Please provide complete information regarding the recognition, intended recipient, and manner of delivery.

NOTE: Flags may be purchased and flown over the Alaska State Capitol in recognition of a person, group, or event. Flags measure 3’x5' and are accompanied with a certificate signed by the Governor noting the date and occasion for which it was flown over the Capitol. Alaska flags cost $36, and U.S. flags cost $24. Requests will be processed once payment has been made to the Office of the Governor.

Please complete the required information above, and send a money order or check for the appropriate amount, made payable to “State of Alaska” to:

Office of the Governor
Attn: Constituent Services
240 Main Street, Suite 301
Juneau, AK 99801

If you have questions regarding your request, please call 907-465-3500.

* Proposed Date/Week/Month:
* Event or Organization affiliated with request:
* Number of signed originals requested:

* Recipient's full rank and title:
* Recipient's branch of service:
* Recipient's years of service:

* Date of Birthday/Anniversary:
* Number of Years:

Constituent Services Request Webform

Please complete all required fields (* indicates a required field)

Salutation:

* First Name:

* Last Name:

* Address:

* City:

* State:

* Zip:

* Phone:

* Email:

* Date Needed:

* Type of Request:

* Proposed Date/Week/Month:

* Event or Organization affiliated with request:

* Number of signed originals requested:

* Recipient's Full Name:

* Recipient's Address:

* Recipient's City:

* Recipient's State:

* Recipient's Zip:

* Occasion:

* Mail recognition to:

* Type of Recognition:

* Recipient's full rank and title:

* Recipient's branch of service:

* Recipient's years of service:

* Date of Birthday/Anniversary:

* Number of Years:

* Recipient's title:

* Recipient's organization:

* Type of Flag:

* Date flag is to be flown:

* Recipient’s Full Name:

* Recipient’s Address:

* Recipient’s City:

* Recipient's State:

* Recipient’s Zip:

* Mail recognition to:

* Proclamation Title:

* Request/Background Information:

* Draft Language for Consideration:

Attach Additional Document: