Queens Contact Form : Constituent Issue Form

First Name *

Last Name *

Street Address *

Street Address Continued

City *

State

Zip Code: *

Email *

Mobile Phone *

Home Phone

Primary Language:

English

Spanish

Mandarin

Cantonese

Hindi

Urdu

Korean

Russian

Arabic

French

Nepali

Bengali

Other

Issue Area *
Please select the policy areas that best describes your issue

Public Assistance

Immigration

Housing

Buildings

Public Safety

Streets and Roadways

Public Transportation

Sewers, Catch Basins, and Flooding

Trees and Parks

Environmental

Sanitation

Noise Complaints

Schools

Health

Small Business

Finance and Tax Liens

Other

Location of Issue * (Please be as specific as possible)

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Constituent Issue Form

Queens Borough President
Constituent Issue Form

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Constituent Issue Form

Queens Borough PresidentConstituent Issue Form

Queens Borough President
Constituent Issue Form