Please fill out & submit to Village Hall as soon as possible. Either send electronically or by mail.

The awardees will be announced & introduced to the public at a special long time residence induction ceremony in conjunction with the Tues night Under the Gazebo concert series, presided over by Mayor, Andrew J. Parise and the members of the Board of Trustees.

Name
Address
Phone #
Previous Address
Yrs. at Present Address
Yrs. at Prior Address
E-mail

I, affirm that I  have been a long time resident for a period of years.

Signed:(if mailed please sign)
   Date:

Incorporated Village of  Cedarhurst residents only.