Block Party Form

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Contact Name     
Address     
Zip Code     
Home Phone     
E-Mail     
Start Time     
End Time     
(REQUESTS MUST BE SUBMITTED TWO WEEKS IN ADVANCE)   
Location of Party(From what street to what street?)     
Note to applicant(s): Only moveable barricades may be used. Blocking streets with vehicles is prohibited.   
Address of Barricade Drop off     
(Barricades will be delivered no later than the Friday preceding the party)   
Date of Party     
Have all neighbors been notified?     
Request for Police to visit block pary if available     
If you would like a visit from the Fire Department please contact Karen Harold at 847-202-6340 to make arrangments.   
Please understand that Police Officers and Firefighters are on duty, and may arrive late, leave early, or not arrive at all. Equipment can be demonstrated and explained.   
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Village Hall Regular Hours: Monday - Friday: 8:00 AM - 5:00 PM
200 East Wood Street, Palatine, Illinois 60067 P. (847) 358-7500
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