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National Night Out

Collierville Police National Night Out Registration

Please provide the following information about your group's activities for National Night Out

Name of Group

Type of Group

Neighborhood Watch
Homeowner Association
Other

Date of Event

National Night Out is scheduled to be held August 2, 2011.

Times of Event

Exact Location of Event

Approximate attendance expected

Please provide your personal information below.

Name

Address

Phone

Email

After submitting this form, you should receive an email listing the information you provided.

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The Town of Collierville does not discriminate on the basis of race, color, national origin, age, sex, or disability in its hiring and employment practices, or in admission to, access to, or operation of its programs, services, and activities pursuant to Title VI of the Civil Rights Act of 1964 (42 U.S.C. 200d) and the Americans with Disabilities Act of 1990, Pub. L 101-336.