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2. First Name*
3. Last Name*
5. Business Name *
7. Address Number*
8. Street Name*
10. City*
11. State*
12. Zip*
14. Phone Number*
15. Email Address*
17. Best way to reach you*

    1. Phone
    2. Email
18. Basic description of business, layout, and size.*
20. Additional information you would like to share (Optional)
22. Consent*

    I am willing to meet and go over the terms of a Building Use Agreement with the Frederick Police Department.

    1. By checking this box, I am willing to meet with a Frederick Police Department Officer to learn more about this program.
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24. 1. Receive an email copy of this form.
25. Email address

    This field is not part of the form submission.

26. Submit Submit and Print

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