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2. 
3. City of Daytona Beach Shores
   2990 S Atlantic Ave
   Daytona Beach Shores, FL 32118
   Phone: 386-763-5353
   Fax: 386-763-5360
5. Name
6. Email Address*
8. Submission Type*
   -- Select One --IssueSuggestion
10. Issue Type*
    -- Select One --Broken Website LinkIncorrect InformationError MessageDifficult to ReadAccessibility Problem
12. URL or Page of Problem*
    URLs can be found at the top of your Web Browser and usually start with http(s)://dbshores.org/
14. Description of Issue or Suggesion
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16. 1. Receive an email copy of this form.
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