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2. Intro
   Please fill form out completely and return to the City Manager’s Office, City Hall, 815 New Bridge Street, Jacksonville NC, 28541. Requests are taken on a first come, first served basis. Please note: Agency requesting color change must complete the Request for Color Change form. Maximum of four days for color change If the color change is for a specific day, such as St. Patrick’s Day, the change will be for that day only. No color change will automatically re-occur.
4. First Name*
5. Today's Date*
   Today's Date
6. Date for Color Change*
   Date for Color Change
8. Last Name*
9. 501(c)(3)*

   1. Yes

   1. No
11. Agency Name and Address*
13. Phone number*
14. Email*
16. Number of days requested*

    1. 1
    2. 2

    1. 3
    2. 4
17. Color Request (upon availability)*
    -- Select One --RedWhiteBlueGreenTealYellowPinkPurpleOther
19. If you selected 'Other' for color request, please include color here:
20. Reason for your request:*
    state the holiday, remembrance or awareness designation
22. Additional Comments
Leave This Blank:


24. 1. Receive an email copy of this form.
25. Email address

    This field is not part of the form submission.

26. Submit

* indicates a required field