Form Center

By signing in or creating an account, some fields will auto-populate with your information.

Council Forms

  1. Community Policing Advisory Committee Contact Form

    Contact form for the Community Policing Advisory Committee (CPAC)

  2. Council Request Form
  3. New Town Council Member Information Worksheet
  4. Request to Speak Form

    Please complete this form if you would like to speak at the next Town Council Meeting during the Citizen/Business Comments portion of... More…

  1. Council Contact Form
  2. Economic Development Advisory Committee Contact Form

    Contact form for the Economic Development Advisory Committee (EDAC)

  3. Planning Commission Contact Form

    Contact form for the Planning Commission

  4. Ribbon Cutting Request Form

    Thank you for your interest in hosting a Ribbon Cutting in Purcellville. Please complete and submit the form at least 2 weeks prior to... More…

Customer Forms

  1. Business Directory Information Form

    This is a form where a business can add/modify/delete information to be contained in the Town of Purcellville's Online Business... More…

  2. Contact Form
  3. FOIA Request Form

    This is a form for citizens to submit a request for public records subject to the Freedom of Information Act.

  4. Personal Property Bill Dispute Request

    This is a form to dispute a bill.

  5. Public Comments on Proposed Budget

    This is a form where you can provide comments to the Town Council on the Proposed Budget.

  1. Citizen Issue//Concern Form

    This form allows you to submit issues with utilities, streets, streetlights, tall grass, trash/recycling, or other community issues and... More…


    The repayment plan allows utility customers additional time to pay their balance as a result of financial hardship from the COVID-19... More…

  3. Payment Plan for Delinquent Utility Bill

    This is a form to request a payment plan for a delinquent utility bill.

  4. Police Department Contact Form
  5. Train Station Rental Application

Parks and Rec Forms

  1. 2024 Celebrate Purcellville Food and Beverage Vendor Application

    The Purcellville Parks and Recreation Advisory Board and the Town of Purcellville are co-hosting the 4th Annual Celebrate Purcellville... More…

  2. 2024 Holiday Market in Purcellville

    Local artisans and crafters are welcome to be part of the 2023 Holiday Market in Purcellville. The cost is $50 per space. The... More…

  3. 2024 Purcellville Music & Arts Festival Vendor Application

    The Purcellville Music & Arts Festival is a free community event featuring multiple stages and performances showcasing local and... More…

  4. 2024 Purcellville Wine & Food Festival - Vendor Application

    Held in the historic Dillon's Woods, the Purcellville Wine & Food Festival features local and regional wineries, restaurants and... More…

  5. Test Form


  1. 2024 Hail to the Trail Registration

    Hail to the Trail - Purcellville's Green Expo is hosted by the Tree and Environment Sustainability Committee, and designed to connect... More…

  2. 2024 Pedal Purcellville

    Sign up for Pedal Purcellville to enter the bike decorating contest and family fun ride through town.

  3. 2024 Purcellville Non-Profit Event Grant Application

    The Parks and Recreation Division and the Purcellville Parks and Recreation Advisory Board have initiated a grant program for local... More…

  4. Application for Special Event Permit
  5. Volunteer Hour Tracking

    This form is to help the volunteers who serve on committees, commissions, and boards related to Parks and Recreation track the number... More…

PPD Forms

  1. Compliment Form

    This form is for filing a compliment regarding an officer’s or other employee's, conduct or the level of service, provided by the... More…

  2. Funeral Escort Request

    The Purcellville Police Department requires 48-hours advanced notice for any funeral escort. Once your online form is submitted, you... More…

  3. Report Aggressive Driving Form

    This form is only for reporting aggressive driving incidents, which took place within the Town of Purcellville. Information submitted... More…

  4. Serialized Inventory
  5. Traffic Complaint Form

    This form is in place to allow community members the opportunity to alert the Purcellville Police Department to potential traffic... More…

  1. Crime Prevention Survey Request

    This form is for requesting a Crime Prevention Survey by a CPTED certified officer, provided by the Purcellville Police Department.... More…

  2. House Check Request Form
  3. Request a Car Seat Safety Check

    We all want our children to travel safely in while in transit. Installing a car seat for younger children and babies can be a... More…

  4. Service Complaint Form

    This form is for filing a complaint against an officer or other staff member of the Purcellville Police Department. Information... More…

  5. VIPS Application

    Application for volunteer position with the Purcellville Police Department.

Purcellville Arts Council

  1. 2024 Artist Application for Art in Town Hall Program - Focus on Nature

    The Purcellville Arts Council has a quarterly Art Show at Purcellville Town Hall, at 221 S. Nursery Avenue. These are shows may be a... More…

  2. 2024 Artist Submission for the Purcellville Music and Arts Festival

    Area artists are invited to showcase their creative works at the Purcellville Music and Arts Festival this year on April 27, 2024! The... More…

  3. 2024 Purcellville Music and Arts Festival, Application for Art Organizations

    We invite local art organizations to participate in the 2024 Purcellville Music and Arts Festival to have a display and activity for... More…

  4. Artist Application to Display at Purcellville Town Hall

    The Purcellville Arts Council is looking for local artists interested in exhibiting their work at Purcellville Town Hall. Please submit... More…

  1. 2024 Artist Application to Participate in Arts in the Garden at the Purcellville Wine and Food Festival

    The Town of Purcellville Arts Council is sponsoring the Arts in the Garden feature at the Purcellville Wine & Food Festival on... More…

  2. 2024 Purcellville Artisan Tour - Artist Application

    The Purcellville Artisan Tour will be held this year on November 2 and 3. The Purcellville Arts Council is pleased to be partnering... More…

  3. 2024 Virginia Commission for the Arts Creative Communities Grant Program Application

    Application for Non-Profit Arts Organizations to be Considered for the Purcellville Arts Council’s 2024 Grant Submission to the... More…

  4. Jim "Doc" Wiley Leadership in the Arts Award for 2023

    The Purcellville Arts Council announces that nominations are now being accepted for the sixth annual Jim “Doc” Wiley Leadership in the... More…