Community Concern Form

Community Concern Form
Use this form to file a concern regarding community issues such as potholes, issues at the community parks such as vandalism or broken equipment, or street light outages.
Complainant's Name (Without proof of Twp residency, complaint is invalid)*

First NameLast Name
Complainant's Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Complainant' Phone#*

Area CodePhone Number
Complainant's E-mail*
Type of Complaint*

Report a Street Light OutReport a PotholeReport a Park Issue
Nature of complaint*
Location of Issue (nearest intersection/address or name of park)*
Upload pictures (optional)

Upload a File

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