VILLAGE OF CRETE

524 WEST EXCHANGE STREET ∙ P.O. BOX 337 ∙ CRETE, ILLINOIS 60417

(708) 672-5431 ∙ FAX: (708) 672-3920

www.villageofcrete.org

*NOTE* Required fields must be filled out before you print or submit form.

Nature of Request:*

Name:*

Address:*

Home Phone:*

Work Phone:

Cell Phone:

Email Address:*

Signature:

Date:

Please return application to:

Village of Crete

524 W. Exchange Street

Crete, IL 60417

OFFICE USE ONLY

Received By:

Date Received:

Resolution:

Date Resolved:

Follow Up Date: (If Applicable)

Date Resolution Forwarded to Contact:

All "Request for Services" must have valid contact information from the person filling out this form. All information must be complete, including signature. Failure to provide all information will void request for service and will result in no further action.
If this is an emergency, please call 911.