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2. First Name*
3. Last Name*
5. Email *
6. Phone number*
8. Would you like us to follow up with you?*

   1. Yes
   2. No
10. Name of Park
    If applicable.
12. Address or Location of the Issue You Are Reporting*

    Intersection, median, etc. Please be specific.

14. What kind of issue are you reporting?*

    1. Irrigation
    2. Mowing / High Grass
    3. Park equipment
    4. Restrooms needing attention
    5. Litter
    6. Graffiti
    7. Lighting or lights not turning on
    8. Other

    Check all that apply.

16. Please describe in detail the Issue you are reporting.*
18. Attach a photo if desired.
19. Attach a photo if desired.
20. Attach a photo if desired.
22. Park and Median Maintenance Info
    Find out more about park and median maintenance.
Leave This Blank:


24. 1. Receive an email copy of this form.
25. Email address

    This field is not part of the form submission.

26. Submit

* indicates a required field