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Shmira Application
This is the general application for Shmira Public Safety
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* Indicates required question
Email
*
Your email
First Name
*
Your answer
Last Name
*
Your answer
Phone Number
*
Your answer
Primary area?
*
Pico - Robertson area.
La Brea area.
The general valley area.
Other:
When is the best time to contact you?
*
Morning
Afternoon
Evening
Other:
A copy of your responses will be emailed to the address you provided.
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