Shamokin, PA · Northumberland County
9/11 Monument Request Form
This application lets an individual or organization request permission from the City of Shamokin to borrow and display the 9/11 monument at an event.
What this form is
This application asks the City of Shamokin to review a request to borrow and display its 9/11 sculpture monument for an event. It records the requester and event details, including location, organization, coordinator, timing, helpers, and a detailed event description. City review and approval are required before planning and hosting the event; submitting the form does not guarantee permission.
Who needs it
An individual or organization seeking permission to borrow and display Shamokin’s 9/11 monument for an event should submit this request.
How to submit it
Return the form to City Hall, 47 E Lincoln St, Shamokin, or email it to [email protected]. The form lists City Hall hours as Monday through Friday, 8–4.
About notarization
This request is signed without a notary; the requester signs and dates it, and the document identifies no notarized attachment or related sworn step.
How to submit this form
- 1
Download The Form
Download the 9/11 Monument Request Form PDF.
- 2
Complete The Request
Provide requester and contact details, event information, and a detailed description of the event.
- 3
Gather Additional Pages
Attach additional pages if needed to provide the detailed event description.
- 4
Submit To The City
Return the form to City Hall at 47 E Lincoln St, Shamokin, or email it to [email protected].
Frequently asked questions
- Do I need a notary for the 9/11 Monument Request Form?
- No. This request is signed without a notary, and the form identifies no notarized attachment or related sworn step.
- How do I submit the 9/11 Monument Request Form?
- Return it to City Hall at 47 E Lincoln St, Shamokin, or email it to [email protected]. The form lists hours as Monday through Friday, 8–4.
- Does submitting the form guarantee permission to borrow the monument?
- No. The city reviews the request, and submission does not guarantee approval. The City Administrator will notify you of the decision and discuss pickup and drop-off details.
- What event details does the form request?
- It asks for contact and event information, including the location, organization, event coordinator, start and end times, helpers, and a detailed event description.