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2. Do you live in: *

   1. Parkland
   2. Spanaway
   3. Frederickson

   1. South Hill
   2. Other
4. Name of Sponsor*
6. Sponsor Street Address*
8. ZIP code*
10. Sponsor Phone Number*
12. Sponsor Email Address*
14. Name of Organization
    If your request is on behalf of an organization, i.e. homeowners association, business park, etc., please indicate the name.
16. Number of stations requested
    -- Select One --12

    Only neighborhoods with more than 100 houses qualify for more than one station at this time. This program may be expanded in the future.
18. Describe proposed station locations
    Indicate approximate address, major landmarks, and whether the property is public or private.
20. If this request is on behalf of an organization, or proposed on community property, do you have permission of all interested parties to install this dog waste station?
    -- Select One --YesNoI don't knowThis is not community property
Leave This Blank:


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

    This field is not part of the form submission.

24. Submit

* indicates a required field