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This form can be used by a new resident to request a login id and password to provide access to the private area of the Kilgore Farms web site. Following submission, the administrator will register the new resident, and email their login information to them.
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| Last Name: | * |
| Resident 1 - First Name: | * |
| Resident 2 - First Name ('N/A' if no second resident): | * |
| Street Address: | * |
| Telephone #: | |
| e-mail Address (Resident 1): | |
| email Address (Resident 2): | |
| Do you have a photograph of yourselves for our directory?: | * |
| To prevent automated SPAM, please enter M9DP to submit your form (case sensitive): | * |
* indicates required field
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