2. Wow! Congratulations on completing your 901 Student Passport. Mayor Harris can’t wait to celebrate your accomplishment. Please use the form below to submit your completed passport page and important information to receive your student’s gift from the Mayor’s Office. You may also mail or drop off your completed passport to the Mayor’s Office. Please only select one option.

   Shelby County Mayor Lee Harris
   Attn: 901 Student Passport
   160 N. Main Street, 11^th Floor
   Memphis, TN 38103 

   Please allow 3-4 weeks for preparing and delivering your student’s gift.

4. Did you use the self-serve one-page passport or the passport booklet? *
   -- Select One --1-page PassportPassport book
6. Upload an image of your completed and stamped passport here. *
8. Upload an image of your stamp pages here. *
10. Upload an image of your Student Information page here. *
12. Student First Name*
14. Student Last Name*
16. Student School*
18. Student Grade for 2022-2023 School Year*
20. Student Age*
    -- Select One --5-89-1314+Other
22. Student Mailing Address*
24. Optional Mailing Address Line 2 (Apt, Unit, Etc)
26. Student City*
    -- Select One --ArlingtonBartlettColliervilleCordovaGermantownLakelandMemphisMillingtonUnincorporated
27. Zip*
29. Optional Email Address to Receive More Correspondence from the Mayor’s Office
31. Optional Note to the Mayor’s Office
Leave This Blank:


33. 1. Receive an email copy of this form.
34. Email address

    This field is not part of the form submission.

35. Submit

* indicates a required field