Contact

Customer Service Request Form

Name*
First Last
Phone*
Email*
Physical Address (Rural Address)*
Address Line 2
Additional Address Information
City Province Postal Code
Category Type*
Request Type*
Request Type*
**Please fill in the additional details below:
Council Meeting Date*
Date Format: MM slash DD slash YYYY
Name of Organization/Person
Name of Presenter(s)
Phone Number
Delegation Topic/Issue/Concern/Etc.
Please provide a brief description of the nature of the presentation and attach any relevant information for Council to consider:
Are you requesting a specific action be taken by Council? If so, please provide a brief outline of the request:
Have you reviewed and understand Westlock County’s Council Delegation Policy?
- Yes
- No
Does the delegation require any special equipment? (PowerPoint, Overhead Projector, etc.)
- Yes
- No
If yes, please indicate what is required.
Request Type*
Request Type*
**Please fill in the additional details below:
Select Public Works Request*
Example: Pothole, washout, debris on road i.e. garbage/trees
Example: Damaged, exposed, plugged
Example: Driveway snowplow flag, custom grading
Example: Regular road maintenance, snow removal, summer grading or washboards
Date*
Date Format: MM slash DD slash YYYY
Legal Land Location of Issue*
Description of Request*
Response Required:*
- Yes
- No
Contact me By:*
- Email
- Phone
Request Type*
Request Type*
Request Type*
Request Type*
Click here to download the Complaint Form
Request Type*
Request Type*
Request Type*
**Please fill in the additional details below:
Legal Land Description*
Account Number (if applicable)
Hamlet*
Lot*
Block*
Plan*
Type of Service Required*
Other
Describe Service*
Remarks
Request Type*
Request Type*
Request Type*
Community Services*
Request Type*
Request Details*
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Files can not exceed 10 MB

Contact Info

10336 – 106 Street
Westlock, Alberta T7P 2G1

Tel: 780-349-3346
Toll Free: 1-877-349-5880
Fax: 780-349-2012
General Email

Office Hours

Monday to Friday 8:00 a.m. to 12:00 p.m. and 1:00 p.m. to 4:30 p.m.

Disclaimer of Accuracy of Customer Information

In order for the Customer Service Requests to be processed and completed please ensure all the fields have been filled out and the contact, land description and concerns are all true and accurate.

Incomplete or inaccurate information will lead in delays in servicing the request.

Contact

Customer Service Request Form

Contact Info

Office Hours

Disclaimer of Accuracy of Customer Information

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