Welcome to the City of Norfolk!
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What is your first name?

 
What is your last name?

 
What email address do you check often (we won't spam you)?

 
What mailing address can we send a confirmation of the class to?

 
What is the best daytime phone number to reach you at?

 
What is your date of birth?

 
What is an emergency contact name?

 
What is an emergency contact phone number?

 
Who is your employer?

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