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Compliment Form

  1. This form is for filing a compliment regarding an officer’s or other employee's, conduct or the level of service, provided by the Purcellville Police Department. * Indicates Required Field/Information

  2. Your Information:

  3. Summary of Interaction:

  4. *Approval for Use on PPD/Town Website The Town of Purcellville would like to share your compliment with the community as part of our Compliments Corner:

  5. Please be aware that information submitted through the Town of Purcellville Government website is considered a Public Record under the Virginia Public Records Act, and may be subject to release by the Town in response to a request made under the Virginia Freedom of Information Act.

  6. Do not submit any unsolicited personally identifiable information including (but not limited to) your: (1) social security number; (2) driver's license number; (3) bank account numbers; (4) credit or debit card numbers; (5) personal identification numbers (PIN); (6) electronic identification codes; (7) automated or electronic signatures; or (8) passwords; or (9) any other numbers or information that can be used to access your assets, obtain identification, act as identification, or obtain goods or services.

  7. Leave This Blank:

  8. This field is not part of the form submission.