Mosquito Spraying Request Form

2. Use this form to report Mosquito problems within the Village of Los Lunas only.

   Please complete all information to enable staff members to correctly identify the area affected.
   Including your name, day time phone number and e-mail address if you wish to be contacted.

   Please note that any message received after 5:00PM (M-F) will forwarded to the responsible agency the next business day.
4. Your Name:*
6. Address:*
8. Phone Number:*
10. E-mail Address:
12. Location of problem, please enter the nearest street address or intersection:*
14. Description of the problem:*
Leave This Blank:


16. 1. Receive an email copy of this form.
17. Email address

    This field is not part of the form submission.

18. Submit Submit and Print

* indicates a required field