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2. Request for Accommodation
   Any person who has a qualifying disability as defined by the Americans with Disabilities Act shall not be excluded from participation in Village meetings. Please advise the Village Clerk 5 days prior to the meeting for special accommodations.
4. Type of Accommodation Request*

   1. Meeting Accommodation Request
   2. Website Accessibility Request
6. First Name*
7. Last Name*
9. Contact Phone Number*
11. Contact Email*
13. Contact Preference*

    1. By Phone
    2. By Email
15. Meeting Accommodation Request
17. Which meeting(s) will you attend?
19. Requested Accommodations
21. Website Accessibility Request
23. Describe the Accessibility Issue on our Website?

    If you cant describe or would like to speak to someone directly please contact Village Hall at 262-782-6700.

Leave This Blank:


25. 1. Receive an email copy of this form.
26. Email address

    This field is not part of the form submission.

27. Submit

* indicates a required field