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2. Please provide your feedback on any issue related to the Village of Carpentersville. Please provide an email address or your phone number if you'd like to receive a response. Thank you for taking the time to contact us.
4. Name*
5. Are You a Village Resident?

   1. Yes

   1. No
7. If you'd like your feedback directed to a particular individual, please provide their name or position:
9. Would you like to be contacted?*

   1. Yes

   1. No
10. If yes, please provide email or phone number:
12. Comments*
Leave This Blank:


14. 1. Receive an email copy of this form.
15. Email address

    This field is not part of the form submission.

16. Submit

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