Contact Botetourt County

2. Submit a request here and your request and/or question will be directed to the appropriate department. 

   You can also use this form to provide constructive feedback/comments/concerns on the usability (i.e. dead links, missing or incorrect information, etc.) of the new site above. The more detail you are able to provide, the better. Please include any links when referring to a specific page.

4. First Name*
5. Last Name*
7. Organization
9. Address
11. City
12. State
13. Zip Code
15. Preferred Contact Method*

    1. Phone
    2. Email
16. Phone Number*
17. Email Address*

    If not applicable, put "n/a"

19. Request/Question*

21. Thank you for your Feedback, if you have any further questions contact the Communications Department- you will be linked to the Communications page once you have completed the survey.

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23. 1. Receive an email copy of this form.
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