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Traffic Issue / Report Form

2. FIrst Name*

3. Last Name*

5. Neighborhood*

7. Phone

8. Email*

10. Specific Issue
    -- Select One --SpeedingTrafficIllegal ParkingIntersection IssueOther (Please Specify)

11. If other, please specify:

13. Street Address / Location of Issue

15. City

17. Is there a particular time of day this issue presents itself?

19. How would you like to be contacted?

    1. Email
    2. Phone

21. Have you contact Huntersville Police Department about this issue before? If so, how long has it been?

23. Is there any other information you wish to provide?

Leave This Blank:


25. 1. Receive an email copy of this form.
26. Email address

    This field is not part of the form submission.

27. Submit

* indicates a required field