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2. Personal Contact Information
   Please submit your personal contact information so that the City can communicate with you during an emergency.
4. Last Name*
5. First Name*
7. Contact Email Address*
8. Cell Phone for Text Messages*
10. Department*

    1. City Manager/City Secretary
    2. Finance, Court & Utility Billing
    3. Fire
    4. Human Resources
    5. Information Technology
    6. Library
    7. Parks & Community Services
    8. Police
    9. Public Works
14. Emergency Contact Information
    Please submit your emergency contact's information so that the City can communicate with them in the event of an emergency.
16. Person's Name*
17. Person's Phone Number*
18. Relationship To You*
Leave This Blank:


20. 1. Receive an email copy of this form.
21. Email address

    This field is not part of the form submission.

22. Submit

* indicates a required field