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2. First Name*
3. Last Name*
5. Your Home Address. (NOT YOUR RENTAL PROPERTY)*
   Please do not place your rental address in this field. We need your home address.
6. RENTAL PROPERTY ADDRESS in Niles
   This is your rental property address that you have in Niles. If you have more than one, please only list one.
8. City*
   Your HOME CITY.
9. State*
   Your HOME STATE.
10. Zip*
    Your HOME ZIPCODE
12. Email*
    You must submit an email address. Submissions without an email address will not be registered for the course
13. Primary Phone Number*
14. Secondary Phone Number
18. Course(s) Offered
20. Please note the dates and times. You only need to sign up for one.*

    1. Class will held in person at the Niles Police Department (7000 W. Touhy Avenue; Niles) on Saturday, January 21, 2023 from 8am to 12pm
    2. Class will held in person at the Niles Police Department (7000 W. Touhy Avenue; Niles) on Wednesday, March 15, 2023 from 5pm to 9pm
    3. Class will held in person at the Niles Police Department (7000 W. Touhy Avenue; Niles) on Saturday, May 6, 2023 from 8am to 12pm
26. Information About Property Owner / Manager
28. The property that you are representing, are you:*

    1. The owner
    2. Property manager
    3. An employee
31. Now many rental properties do you have in Niles:*

    1. One
    2. Two or three
    3. Four or more
    4. none
33. If you are registering for another communities Crime Free Housing Course, what community?
35. Course Location:

    All classes will be offered in person unless otherwise stated.

Leave This Blank:


37. 1. Receive an email copy of this form.
38. Email address

    This field is not part of the form submission.

39. Submit

* indicates a required field