2. Address of Encampment
4. City
6. Number of people:
8. Property Type
   -- Select One --PublicPrivateUnknown
10. Add Photos

    Note: please upload two (2) photos. One photo should be the a closeup of the encampment (if possible) and the other should show the context where the encampment is located. This will greatly help our crews efficiently respond to your request. Please note that if no photos are provided, we will need as accurate location and description as possible.

12. Please describe the encampment and provide as specific a location as possible.
14. May we contact you with further questions if needed?

    1. Yes
    2. No
16. Name
17. Email
19. Phone Number
Leave This Blank:


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

    This field is not part of the form submission.

23. Submit Submit and Print

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