Form Builder

Report A Malfunctioning Street Light

1. Your Contact Information

We will require some basic contact information to process your request in the event that we need to follow-up, request additional information, or report on progress. All contact information fields are required.

2. Streetlight Location & Additional Information

Additional information may be required to handle your request. Any required fields are labeled with a red asterisk (*).

Location of Malfunctioning Streetlight

Personal information on this form is collected under the authority of Section 10(1) of the Municipal Act, 2001, S.O. 2001, c.25, as amended and will be used to contact you concerning your service request/inquiry to the City of Brantford. Questions about this collection should be directed to:

City of Brantford Customer Contact Centre
Brantford City Hall
100 Wellington Square
Brantford, ON N3T 2M2
Telephone: 519-759-4150
Email: customercontact@brantford.ca