Submit a Request PF - Civic Clarity Demo

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Potential Form Request Example

Explain what you need, and we'll make sure that your request is assigned to the correct person.

"*" indicates required fields

Δ

Name

This field is for validation purposes and should be left unchanged.

Name*

Email*

Phone

Message

Message to go to:*

General Mailbox

Supervisor

Treasurer

Clerk

Information Needed for Service Issues

Street Light Burned Out

Garbage Pick Up Missed

Address

List address or cross roads

Explain why you are sending us image(s)

Date Image(s) Taken*

If you are not sure the date, state that you are estimating the date.

Phone image

Drop files here or

Accepted file types: jpg, png, heic, heif, , Max. file size: 512 MB, Max. files: 4.

"*" indicates required fields

Δ

URL

This field is for validation purposes and should be left unchanged.

Name*

Email*

Phone

Message

Message to go to:*

General Mailbox

Supervisor

Treasurer

Clerk

Information Needed for Service Issues

Street Light Burned Out

Garbage Pick Up Missed

Address

List address or cross roads

Explain why you are sending us image(s)

Date Image(s) Taken*

If you are not sure the date, state that you are estimating the date.

Phone image

Drop files here or

Accepted file types: jpg, png, heic, heif, , Max. file size: 512 MB, Max. files: 4.

Example of confirmation once form is submitted

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