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Town of Walkerville

Request for maintenance / Report an issue.

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Privacy Statement

All details provided to Council are confidential and will not be disclosed. Your details are for our records only and will assist us with ensuring a prompt response is received by yourself and the issues raised, resolved.

Contact Details
Your Details
First Name*
Last Name*
Residential Address*

I.e. 66 Walkerville Terrace, Gilberton SA 5081

Postal Address

Leave blank if your postal address is the same as residential address.

Contact Phone*
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Contact Phone B
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Contact Phone C
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E-Mail Address
Request Details
Date of Occurence*
(dd/mm/yyyy)
Description*

Please include as much detail or include photographs where possible, to assist council with your report.

Max combined file size is 25mb

Responsible Party [If Applicable]

Council Employee or Department

Suggested Resolution
Add a Cc
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Send a copy of the submitted form to this email address.