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2. Pursuant to Winnetka Village Code, Title 1, Chapter 1.12, “Americans with Disabilities Act,” it is the policy of the Village of Winnetka to comply with the Americans with Disabilities Act of 1990 (ADA) in the delivery of Village services, programs and activities, by making reasonable accommodations for people with disabilities. The form below is to submit a complaint about alleged discrimination in the delivery of Village services, programs, and activities. The ADA Coordinator will respond to complaints within 15 calendar days.

4. Date of Incident*
   Date of Incident

   Date of Incident
5. Location of Incident*
7. Description of Incident*
9. Name*
10. Email Address*
12. Address
14. City
15. State
16. Zip code
18. Phone Number*
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20. 1. Receive an email copy of this form.
21. Email address

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22. Submit

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