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Village of Rosemont Contact Information
We keep an official contact list for Rosemont residents that we use to inform folks of Village business. Please complete the following form, indicating the best email address and phone number by which we can reach you when needed. We will
NOT
share this information. Thanks in advance!
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* Indicates required question
On which street do you live?
*
Chick Lane
New York Avenue
Petersville Road
Rosemont Drive
Souder Road
What is your house number on this street?
*
Your answer
How many adults (age 18+) currently consider this their permanent mailing address, including, for example, college students away at school part of the year?
Choose
1
2
3
4
5
More than 5
Adult #1 Last Name
*
Your answer
Adult #1 First Name
*
Your answer
Adult #1 Preferred Email Address
*
Your answer
Adult #1 Email Preferences (check all that apply)
*
Official Village Business: Messages from Burgess; announcements of Village meetings, elections, bulk trash pick-up dates, etc.
Unofficial Village Business: Lost and found pets, local community events, requests for assistance (e.g., snow removal, lawn care), etc.
Required
Adult #1 Preferred Phone Number
Your answer
Adult #2 Last Name
Your answer
Adult #2 First Name
Your answer
Adult #2 Preferred Email Address
Your answer
Adult #2 Email Preferences (check all that apply)
Official Village Business: Messages from Burgess; announcements of Village meetings, elections, bulk trash pick-up dates, etc.
Unofficial Village Business: Lost and found pets, local community events, requests for assistance (e.g., snow removal, lawn care), etc.
Adult #2 Preferred Phone Number
Your answer
Names, contact information, and email preferences for any additional adults in your household (alternatively, they may fill out their own separate survey):
Your answer
Thank you!
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