Phone: 970-549-5000
Address: 555 Ute Avenue
Grand Junction, CO 81501
E-Mail: GJPD@gjcity.org

Photo by Laurie Purcell

National Night Out Registration Form

YOU MUST SELECT TODAY'S DATE!

April 2024

Sun

Mon

Tue

Wed

Thu

Fri

Sat

Block Leader's Name

*Your name and evening phone will be displayed for interested parties

Block Leader's Address

Address of Event

Block Leader's Daytime Phone

Block Leader's Evening Phone

*Your name and evening phone will be displayed for interested parties

Block Leader's Email

(Adults)

(Kids)

Special Requests

NOTE: There is NO grant money available this year.

Submit Registration Form Cancel