Register My Community

Community Registration Form

Please complete the form below to register your community with the 10 by 10 Challenge.

(A "Champion" is someone who is leading the Challenge for your community. Fill-in the Champion field if that is someone other than the Mayor.)

Community Information
Community Name:
Mayor Name:
Champion Name:
Champion Title:
Contact Information
Contact Name:
Email:
Phone Number:
Mailing Address
Street Address:
City:
Postal Code: