E&R Car Giveaway Registration
must be current resident of the 16th ward.
Name
*
First Name
Last Name
E-mail
*
example@example.com
Address (optional)
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
*
Upload proof of residency. (Driver License Required) (Voters Registration, Current Lease, Or Tax Bill)
*
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