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2. First Name*

   (Note: testimonial attribution will consist of your first name and last initial. Example: "John D.")

3. Last Name*
5. Attribution*

   May we attribute your testimonial using your first name and last initial? (Example: Jane D.)

   1. Yes
   2. No; I wish to remain anonymous.
7. Residency

   Are you a resident of the Town of Normal? (Note: you do not have to be a resident of Normal to submit a testimonial.)

   1. Yes
   2. No
9. Topic
   -- Select One --Festivals and eventsUnderpass/Connector projectOpen Data PortalOther

   What is your testimonial regarding?

11. Testimonial*
13. Permission to Publish*

    By checking this box, I hereby grant permission to the Town of Normal Communications Department to publish my testimonial—in full or in part—in official media channels including but not limited to social media, email communications, video, advertisements, graphic displays and more.

    1. I grant permission to publish.
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15. 1. Receive an email copy of this form.
16. Email address

    This field is not part of the form submission.

17. Submit

* indicates a required field