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2. 
4. First Name*
5. Last Name*
7. Property Address*
9. Property Type

   1. Private Single-Family Home
   2. Condominium Complex
   3. Restaurant
   4. Bar/Lounge
   5. Hotel/Motel/Resort
   6. Retail Establishment
   7. Other
10. Other Property Type

    Please describe your property type, for example: a parking lot

11. Property Name*

    Please enter the private residential, condominium or business name. If no name, enter N/A.

13. Contact Telephone Number*
14. Email Address*
15. Property Website URL*

    If no website, please enter N/A.

17. Request for More Information*

    1. Yes, I am already compliant and am interested in scheduling a certification review now.
    2. Yes, I am interested in learning how I can become more compliant.
    3. I am unsure if I am compliant. Please contact me so I can learn more.
    4. No, I do not want a certification review at this time, however I am interested in learning more about the recognition program.

19. Thank You!

    Thank you for your interest in the City of Hollywood Turtle Friendly Lighting Recognition Program. By taking this first step, you are on your way to helping us save more sea turtles in Hollywood. 

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

    This field is not part of the form submission.

25. Submit

* indicates a required field