TOWN OF EAST LONGMEADOW
60 CENTER SQUARE
EAST LONGMEADOW, MA 01028
CITIZEN SERVICE REQUEST FORM
Citizens may use this form to request services from Town Departments. So that we may better serve you,
please make sure to provide all the required information, and submit this form to the Town Manager’s Office
or by email: TownManager@eastlongmeadowma.gov
This form is for NON EMERGENCY request only. For immediate response in emergency situations please call
911.
Choose from the following Departments:
□ Accounting Department □ Fire Department □ Police Department
□ Assessors Department □Health Department □ Public Works
□ Building Department □ Historical Commission □ Recreation Department
□ Collector-Treasurer’s Office □ Information Technology □ Town Clerk
□Council on Aging □ Library □ Town Council
□ EL Cable Access Television-ELCAT □ Planning Zoning & Conservation □ Town Manager
Please provide the following information:
Name: Date:
Email:
Address:
City:
Phone:
Alt Phone:
Would you like a staff member to contact you about your request? □ Yes □ No
Preferred Contact Method: □ Email □ Phone
Additional Info/Brief Description:
Note: Per MGL 148A §2; Fine: Whoever, upon request of any local code enforcement officer, refuses to state his name and address, or if he states a
false name and address or a name an address which is not his name and address in ordinary use, shall be punished by a fine of not more than $200.
