Sign Up Form

The collection site at the Jordan PD Parking Lot (705 Syndicate St.) is open to registered users ONLY. By signing up, you agree to the site policies. More information available at www.jordanmn.gov
After signing up, please watch your email inbox for notification when your key fob is ready (CHECK YOUR SPAM/JUNK MAIL INBOX)

Question Title

* 1. What is your first and last name?

Question Title

* 2. What is your street address?

Question Title

* 3. What is your phone number?

Question Title

* 4. What is your email address?

Question Title

* 5. What is your residency?

Question Title

* 6. Are you applying for use for a household or a restaurant?

Question Title

* 7. What site options do you intend to use?

Question Title

Site Rules

Site Rules

Question Title

* 8. Have you read the above rules and agree to follow them?

T