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2. Contact Information
   Passes with a expiration date of December 31, 2019 will be valid through June 30, 2020.
4. First Name*
5. Last Name*
7. Email Address*
9. Address*
11. City*
12. State*
13. Zip Code*
15. Telephone Number*
17. Would you like to pick up the card at City Hall or have it mailed to you?*
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19. 1. Receive an email copy of this form.
20. Email address

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