Assistance Form

Please be warned that the City of Bogalusa strongly objects to the use of its Assistance Forms or the Internet for illegal and immoral activities and will vigorously prosecute those who knowingly and illegally abuse the site. The City of Bogalusa will cooperate with Federal, State, Parish and Local law-enforcement officials in the pursuit of criminal activities and those who perpetrate such activities.

Use this form to request assistance, record a complaint, or request help with a problem. Forms received without information marked as required will be disregarded.

When you have completed the information below, press the "Submit Form" button to send to the appropriate city department, or press "Clear Form" to begin again.

Name (required):
Work Phone: (one phone # required)
Home Phone: (one phone # required)
E-mail:
Enter Assistance Type:
Enter Location (required):
Detailed Explanation & Location of Problem:
Comments or Recommendations:

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Terms of Use and copyright information

Assistance Form

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� 1914-2010, City of Bogalusa, all rights reserved. P. O. Drawer 1179 � Bogalusa, LA 70429-1179 202 Arkansas Avenue � Bogalusa, LA. 70427 Phone 985-732-6200 � FAX 985-732-6245

� 1914-2010, City of Bogalusa, all rights reserved.
P. O. Drawer 1179 � Bogalusa, LA 70429-1179
202 Arkansas Avenue � Bogalusa, LA. 70427
Phone 985-732-6200 � FAX 985-732-6245