1

First and Last Name 

 *

First and Last Name

2

Phone Number

 *

Phone Number

3

Email Address

 *

Email Address

4

Street Address

Street Address

5

City, State, Zip Code

City, State, Zip Code

6

Share your story about a notable person, place, or moment in Prairie Village. 

Share your story about a notable person, place, or moment in Prairie Village.

7

Attach a photo

Attach a photo Click button for uploading file Clear Maximum size allowed: 5 MB Allowed types: .gif, .jpg, .jpeg, .png, .doc, .docx, .xls, .xlsx, .rtf, .pdf, .txt

8

Attach a photo

Attach a photo Click button for uploading file Clear Maximum size allowed: 5 MB Allowed types: .gif, .jpg, .jpeg, .png, .doc, .docx, .xls, .xlsx, .rtf, .pdf, .txt

9

Attach a photo

Attach a photo Click button for uploading file Clear Maximum size allowed: 5 MB Allowed types: .gif, .jpg, .jpeg, .png, .doc, .docx, .xls, .xlsx, .rtf, .pdf, .txt

10

Attach a photo

Attach a photo Click button for uploading file Clear Maximum size allowed: 5 MB Allowed types: .gif, .jpg, .jpeg, .png, .doc, .docx, .xls, .xlsx, .rtf, .pdf, .txt

11

Attach a photo

Attach a photo Click button for uploading file Clear Maximum size allowed: 5 MB Allowed types: .gif, .jpg, .jpeg, .png, .doc, .docx, .xls, .xlsx, .rtf, .pdf, .txt

12

I understand that the images or testimonials submitted may be used by the City of Prairie Village in printed or electronic materials, including but not limited to newsletters, history books, social media, and websites. I understand that no royalty, fee or other compensation shall become payable to me by reason of such use, and I waive any claims for intellectual property ownership and release the City for any use of my submission.

 *

I agree

1. To receive a copy of your submission, please fill out your email address below and submit.
2. Email Address

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