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Neighborhood Traffic Safety Program

2. Neighborhood Traffic Safety Program
   Print this form out

   NOTE: The Neighborhood Speed Watch Program requires volunteers involved to pass a criminal background check. QUESTIONS? Contact the St. Joseph Police Traffic Unit at 816-271-5359. If you would rather print the form out, you may fax it to 816-271-5376

4. Name*

6. Address1*

8. Address2

10. City*

11. State*

12. Zip*

14. Date of Brith
    Date of Brith

16. Phone Number*

18. Email Address*

20. Neighborhood Group or Association

22. Name of Primary Street of concern*

24. Nearest cross street*

26. What concerns have you identified with the above location?

28. Please provide contact names and phone numbers for the Neighborhood Association or Neighborhood Watch

30. Please check the items that you are requesting:

    1. Neighborhood SpeedWatch (Radar Loan Program)
    2. Traffic Safety Yard Sign Program
    3. Radar Trailer

Leave This Blank:


32. 1. Receive an email copy of this form.
33. Email address

    This field is not part of the form submission.

34. Submit

* indicates a required field