Lilburn Next & Lilburn Now

2. Do you want to make a difference in our community? The City of Lilburn is forming two focus groups to help guide leadership in making key short-term and long-term decisions for the future of Lilburn. If interested, complete the registration form below; based on your age, you will be sorted into either Lilburn Next (18-24 years) or Lilburn Now (25-40 years). 

4. First Name*
5. Last Name*
7. Email Address*
8. Phone Number (Cell)*
10. Street Address Line 1*
12. Street Address Line 2
14. City*
15. State*
16. Zip Code*
18. Which Age Group Do You Fall Within?*

    This will determine your registration for either Lilburn Next (18-24) or Lilburn Now (25-40). We are not accepting registration for other age ranges at this time. 

    1. 18-24 Years Old (Lilburn Next)
    2. 25-40 Years Old (Lilburn Now)
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20. 1. Receive an email copy of this form.
21. Email address

    This field is not part of the form submission.

22. Submit

* indicates a required field