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2. Program Information
   Do Not Knock Program Information
3. Date
   Date
5. First Name
6. Last Name
8. Address
9. City
10. Zip Code
12. Phone Number
13. Email Address
15. Add my address to the "Do Not Knock Registry":

    1. Yes
    2. No
17. Remove my address from the "Do Not Knock Registry":

    1. Yes
    2. No
19. I give my consent the City of Bay Village to add/remove my information to/from the Do Not Knock Registry:

    1. Yes
    2. No
Leave This Blank:


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

    This field is not part of the form submission.

23. Submit

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