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W10=
*
First Name
*
Last Name
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E-Mail Address
Phone Number
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I am a...
*
I am a...
Resident of Ahoskie
Business Owner
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Other
Please include details of the issue or concern you would like to notify the Town Management of:
Would you like someone to follow up with you about this issue?
Would you like someone to follow up with you about this issue?
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No
Best Method of Contact:
Best Method of Contact:
Email
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Best Time to Call:
Best Time to Call:
Morning
Afternoon
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