Street Light Issue Form
Street light/Pole Number
*
Villiage of District
*
Please Select
Nikao
Ruatonga
Avatiu
Panama
Atupa
Takuvaine
Tupapa
Matavera
Ngatangia
Titikaveka
Muri Ennua
Akaoa
Ruaau
Short description of the location of the street light pole
Issue
*
Please Select
Street light reported multiple times
Street light does not come on at night
Street light stays on all day
Street light has been removed and not yet replaced
Street light is too bright
Street light is flickering
other
Attach a photo of the street light issue (if possible)
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Name
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Last Name
Contact Number
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Format: (682) 00-000.
Email Address
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