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Citizen Request for Services Form

  1. Use this form to request or report the following: repair of street or potholes, street drainage problems, street sign issues,streetlight outage (provide streetlight pole number). Your name, telephone number, and e-mail address are not required, but are helpful should questions arise.

  2. Reported location must be within the Town of Wilson Boundaries. The exact reported location/site address is required

  3. Please use one form per request!

  4. Contact Information

  5. Exact Location of Job Requested

  6. Leave This Blank:

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