If you would like to receive a face mask and sticker for taking the pledge, please provide your mailing address:

(or Irvine business)

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Please fill in your name and email and then either draw or type your signature below.

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I agree to electronically sign and to create a legally binding contract between the other party and myself, or the entity I am authorized to represent.

Additional Signatures Required

City of Irvine Public Information Office

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