Form Center

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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.

  2. COVID-19/ FINANCIAL HARDSHIP UTILITY REPAYMENT REQUEST

    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. 2023 Celebrate Purcellville Food Vendor Application

    The Purcellville Parks and Recreation Advisory Board and the Town of Purcellville are co-hosting the 3rd Annual Celebrate Purcellville... More…

  2. 2023 Hail to the Trail Registration

    Participate in the 2023 Hail to the Trail! Share information about your non-profit and lead a fun hands-on activity for families. The... More…

  3. 2023 Independence Day Parade Application Form

    Thank you for your interest in being part of the 2023 Purcellville Independence Day Parade! The annual Independence Day Parade will be... More…

  1. 2023 Celebrate Purcellville Registration

    The Purcellville Parks and Recreation Advisory Board and the Town of Purcellville are co-hosting the 3rd Annual Celebrate Purcellville... More…

  2. 2023 Holiday Market Vendor Form

    Local artisans and crafters are welcome to be part of the 2023 Holiday Market in Purcellville. The cost is $25 per space. The... More…

  3. Application for Special Event Permit

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. Serialized Inventory
  4. 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. Report Aggressive Driving Form

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

  3. Service Complaint Form

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

Purcellville Arts Council

  1. 2023 Artist Application to Participate in Arts in the Garden at the Purcellville Wine & Food Festival

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

  1. 2023 Purcellville Artisan Tour - Artist Application

    The Purcellville Artisan Tour will be held this year on November 4 and 5, from 12:00 p.m. to 5:00 p.m. each day. The Purcellville Arts... More…