2. What are you requesting?*
   -- Select One --Proclamation or GreetingWedding Reservation
4. Full Name*
5. Email Address*
7. Address*
9. City*
10. State*
11. Zip Code*
13. Phone Number*
14. Fax Number
16. Date for Wedding Ceremony*
    Date for Wedding Ceremony

    Please note that weddings are conducted only on the 4th Monday of each month.

20. Individuals to be Married:
22. First Name*
23. Last Name*
25. First Name*
26. Last Name*
28. Please read and check BOTH boxes before submitting:*

    Weddings are held in the City Commission Chambers at City Hall (101 W. Third Street). A fee of $50 is required for any wedding ceremonies performed by the Mayor's Office. Wedding fees must be paid by cash, certified check or money order made payable to the City of Dayton in advance in order to secure the reservation.

    1. I have read and understand the requirements regarding weddings with the Mayor's Office.
    2. I agree to pay $50 and that this will secure my reservation with the Mayor's Office.
30. Type of Request*

    1. Proclamation
    2. Greeting
31. Date of Event
    Date of Event
33. Location of Event
34. Date Requested By:*
    Date Requested By:
    When is your deadline to have the proclamation or greeting in-hand?
36. Remarks*
    Please provide the exact language you want included in the Proclamation or Greeting. Refer to this sample document for assistance.
38. Please attach any supporting documents
Leave This Blank:


40. 1. Receive an email copy of this form.
41. Email address

    This field is not part of the form submission.

42. Submit

* indicates a required field