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City of Grand Junction
webforms@gjcity.org
CO
,
US
Section 1 of 1 in this document
Liquor License Survey
Full Name
First Name
*
Initial
Last Name
*
Unique ID from Address Label
*
Do you certify you are 21 years of age or older?
*
Choose One
Yes
No
The Address on the mailed Notice is my:
Residence
Business
Concerning the liquor license application as described in the Mailer
*
Choose One
I Support the new license being issued
I Oppose the new license being issued
Please feel free to include any additional comments.
disregard this
