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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.

  6. Train Station Rental Application
  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. Streetlight Issue Form

Parks and Rec Forms

  1. 2022 Application for Purcellville NeighborWoods Program
  2. 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…

  3. 2023 Purcellville Music & Arts Festival Exhibitor Application

    The Purcellville Music & Arts Festival is a free community event featuring multiple stages and performances showcasing local and... More…

  4. 2023 Purcellville Wine & Food Festival - Exhibitor Application

    Held in the historic Dillon's Woods, the Purcellville Wine & Food Festival features local and regional wineries, restaurants and... More…

  5. 2023 Rock the Rink Vendor Application

    The Rock the Rink event features performances showcasing local and regional music at the historic Bush Tabernacle. Rock the Rink is... More…

  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 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. 2023 Purcellville Music & Arts Festival Food Vendor Application

    The Purcellville Music and Arts Festival is a free community event featuring multiple stages and performances showcasing local and... More…

  4. 2023 Purcellville Wine & Food Festival - Food Vendor Application

    Held in the historic Dillon's Woods, the Purcellville Wine & Food Festival features local and regional wineries, restaurants and... More…

  5. 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 Submission for the Purcellville Music and Arts Festival

    The Purcellville Music and Arts Festival showcase the many performers and artists living and working in this area, the Purcellville... More…

  2. 2023 Virginia Commission for the Arts Creative Communities Grant Program Application

    2023 Application for Non-Profit Arts Organizations to be Considered for the Purcellville Arts Council’s Grant Submission to the... More…

  1. 2023 Purcellville Music and Arts Festival, Application for Art Organizations

    We invite local art organizations to participate in the 2023 Purcellville Music and Arts Festival to have a display and activity for... More…