In accordance with La Grange Village Ordinance 0-90-54, I request that my address be added to the residential "No Solicitation" list. I attest that I am the residential owner or occupant of the address I am providing. I further understand that I must provide written notification to the Police Chief if I wish to be removed from this list at a future date.

Residential Owner / Occupant Name*

La Grange Address*

Date Submitted (Please enter in this format: MM/DD/YYYY)*

For a current list of approved solicitors, please visit the "Solicitation Licenses Issued" link.

Solicitation Licenses Issued