Please note that name, address, and telephone numbers are required.  

Name:

Address:

City:     State:          

Zip:

Telephone:           

Email:

Check all that apply:

My subject today is regarding:

Information Request	The Rebate Program	The Riding Center
Tennis Courts	Softball Field	Web Site
Volunteer for Park District		Other

You could categorize my comments as:

A suggestion	Need for repair or maintenance	A complaint
Feedback	Praise	A request

Please write your comments:

Yes, I would like to be contacted, please call.	Please call: daysnights	Phone:
Please post my question.	Please post a response to my question.
No, I do not wish to be contacted.