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2. By registering, I understand that my address shall be placed upon a list to be distributed to any licensee who is issued a license to conduct door-to-door sales pursuant to Section 256-9(B) (iii) of Ordinance Number 7-19 of the Revised General Ordinances of the City of Long Branch.

   I am requesting registration of the following address upon the City of Long Branch's "No Knock Registry."

   Note: Upon receipt of a completed No Knock Registry Application Form, a decal will be mailed to your residence. This decal should be placed on the premises. A residence shall remain on the registry until a request is made in writing by the property owner to the City Clerk to have such residence removed from the registry.

4. Name*
6. Street Address*
8. Apartment/unit number (if applicable)
10. Contact Information (email or phone)*
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12. 1. Receive an email copy of this form.
13. Email address

    This field is not part of the form submission.

14. Submit

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