Peddlers/Solicitors application

Complete the application below and select the Submit button. The information you provide will be automatically sent to the village. A village representative will then contact you.

For complete details about this form click here.

Name of Applicant *

Phone Number *

Email Address *

Street Address *

Date of birth *

Name of Company Represented *

Company Address *

Company Phone Number *

Vehicle Number *

Type of Vehicle *

License Plate Number *

Type of goods, wares, merchandise or services *

Method of distribution *

Length of time license requested *

Do you have a Certificate from Sealer of Weights and Measures? If so, you must bring it to the village office.

Yes

Do you have a Surety bond or cash in the amount of $500.00? It is required so you must bring it to the village office.

Yes

Draw your signature in the space below using a mouse, stylus, or your finger.

Check this box to attest that this application is your own and the information it contains is as accurate as possible.