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4. Contact Information
6. First Name*
7. Last Name*
9. Address*
11. City*
12. State*
13. Zip*
15. Phone Number*
16. Date of Order
    Date of Order

    Date of Order
18. E-Mail Address
19. Preferred Method of Contact
    -- Select One --PhoneE-Mail
23. Please list the characters you would like on the sign. Maximum of 5 characters for a horizontal sign and 4 characters for a vertical sign. Numbers (0-9) and Letters (A-Z) are acceptable. Directional arrows may be used as a character. If you would like directional arrows, please include this in the comments section below and someone will contact you for follow up.
25. Address Number Requested
27. Select Orientation and Post Option

    1. Vertical
    2. Horizontal

    1. With Post ($20)
    2. Without Post ($15)
28. Mounting Options
    
30. Additional Instructions/Comments
32. Note:

    Once the requested sign is completed you will be notified via telephone or email. At that time arrangements can be made to pick up the sign from Carrboro Fire-Rescue Station No. 1 at 301 W. Main St. Carrboro, NC 27510. Payment will be collected when the sign is picked up. Personal check or credit card are the preferred methods of payment. 

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34. 1. Receive an email copy of this form.
35. Email address

    This field is not part of the form submission.

36. Submit

* indicates a required field