Milestone Recognition
Applicants must be at least 18 years old and a reside in Coral Springs to be eligible to complete this application.
Your Name
*
First Name
Last Name
Your E-mail Address
*
Your Contact Number
Add the best number to contact you.
Format: 000-000-0000.
Recipient’s / Business Address
*
Street Address
Street Address Line 2
City
Please Select
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
Type of Recognition
*
Long-Term Resident (40 years or more)
Long-Term Business (25 years or more)
Newborn Recognition
Naturalization Recognition
Resident name
*
First Name
Last Name
Business name
*
Years of residency
*
Years of business operation
*
Baby's name
First Name
Last Name
Baby's date of birth
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Name of person that was naturalized
*
First Name
Last Name
Date of naturalization
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
I verify this submission meets the program criteria. By typing my name in the below space, I am electronically signing this form. By signing this electronic signature certifies the information to be true, accurate, and complete.
*
First Name
Last Name
Submit
Should be Empty: