Snow Removal Request Form

Snow Removal Request Form

Service offered only to seniors (age 60+) and neighbors with disabilities within the zip codes 60629, 60632, and 60638.
Name

First NameLast Name
Phone Number
Please enter a valid phone number.
Email
example@example.com
Location

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Any additional info you would like to add?
Please note that services are not guaranteed. Our capacity is determined by the size of our volunteer team. We'll do our best to assist as many people as possible. Thank you for understanding.
Should be Empty: