Chicago 311

Submit Senior Related Literature Request Request

Location

Enter street address to search.
Long-click and hold on map pin, then drag to adjust location.

Photo

Description

Senior's Last Name

Senior's First Name

Senior's Date of Birth

Literature Requested? (Select all that apply):

If other please describe?

Literature will be mailed to Senior's address below.

Gatekeeper Call?

Carrier Alert Call?

Receive mobile text updates?

Reporter

First name

Last name

Enter an email address to receive a tracking number

Phone

Enter as 999-999-9999

This service request is used to have brochures and/or literature sent out for senior citizen-related programs and services.

Describe the issue you wish to report including a photo and/or a description.
* Indicates a required field.