2. 

4. Best of Jurupa Valley Beautiful Home Award Program

   Please complete the form below with the information on the property nominated.

6. Address of property being nominated: (Required)
8. Homeowner First Name: (Optional)
9. Homeowner Last Name: (Optional)
11. Homeowner phone number: (Optional)
13. Homeowner email: (Optional)
15. Which City Council District is the home located? (please see the district map and check the corresponding box)

    1. District 1
    2. District 2

    1. District 3
    2. District 4

    1. District 5
17. Reason for nomination:
19. Please upload 3 photos of the exterior of the home for review (Optional)
21. Photo 1
22. Photo 2
23. Photo 3

25. To complete this submission, please enter yhour email address again and click SUBMIT at the bottom of the page.

27. 
29. 
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31. 1. Receive an email copy of this form.
32. Email address

    This field is not part of the form submission.

33. Submit

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