Presidential Greetings Form

If you're a resident of Illinois's 14th District and would like to receive a greeting from the President of the United States, please complete the form below. I would be happy to help you in securing any of the following:

• Birthday Greetings (for persons 80 years of age or over)
• Anniversary Greetings (for couples celebrating 50 years of marriage or more)
• Wedding (send your request after the event)
• Baby's Birth

* indicates information that you need to provide.

Contact Information

First Name: *

Last Name: *

Street Address: *

Street Address Continued:

City:*

State:* IL

Zip Code:*

Email:*

Telephone

Daytime Telephone Number: Voice VP TTD

Evening Telephone Number: Voice VP TTD

Honoree Information

Full Name: *

Street Address of Honoree: *

City: *

State:* IL

Zip:*

Greeting Requested:
Birthday Anniversary Wedding Baby's Birth

Exact Date of Occasion:

Please provide other necessary information below: