Municipal Service Request

Please complete the form below to and click submit to send your request.

Choose from the following *

Traffic Sign Request

Street Sign Request

Pot Hole Repair Request

Illegal Dumping Pickup Request

Outage, Damage or other Issue related to Street Light (Please enter Below in Brief Description, nearest Home address to the Street Light)

Dirt Road Maintenance ( Please enter Below in Brief Description request location and maintenance required)

Other (Leave a Brief Description Below)

Name *

Email Address *

Phone *

Date

Brief Description

Leave this field blank

312 S. Main Street
P.O. Box 98
Malvern, AL 36349