2. Name of Group/Organization:*
4. Address:*
6. City:*
7. State:*
8. Email:*
10. Dates of Solicitation:*
11. Hours of Solicitation*
13.  

    The following person will directly supervise the solicitation:

15. Last Name:*
16. First Name:*
17. Middle Initial:
19. City:*
20. State:*
21. Date of Birth:*
23. State where ID/Driver's License Issued From: *
24. Mobile Number:*
26. Certification Statement:

    I certify and affirm that he/she is an authorized representative of the organization whose name appears on this form and that participants will comply with the provisions contained in Chapter 46 of the Wheaton City Code. I certify that all the above statements are true to the best of my knowledge, information, and belief. I further attest that I will promptly notify the Chief of Police regarding any changes to the information that I have provided on this form.

28. Name:*
29. Title:*
30. Date:*
    Date:
32. Confirmation of Signature*

    1. I understand that checking this box constitutes a legal signature confirming the statements made above.
34.  

    Completed applications will be processed Monday thru Friday between the hours of 8:00 a.m. and 4:00 p.m. Applications will be processed within 48 business hours from the time and date received.
    
    Please provide below information for each person 15 years of age and over intending to engage in commercial solicitation.

36. Last Name:*
37. First Name:*
38. Middle Initial:
39. Date of Birth:*
    Date of Birth:
41. Address:*
42. City:*
43. State:*
45. State where ID/Driver's License Issued From:*
47. Has this person been convicted of a felony under any state or federal law within the last five years?*

    1. Yes
    2. No
49.  

    1. Check this box if you need to add another person who will be engaging in the commercial solicitation.
51. Last Name:
52. First Name:
53. Middle Initial:
54. Date of Birth:
    Date of Birth:
56. Address:
57. City:
58. State:
60. State where ID/Driver's License Issued From:
62. Has this person been convicted of a felony under any state or federal law within the last five years?*

    1. Yes
    2. No
64.  

    1. Check this box if you need to add another person who will be engaging in the commercial solicitation.
66. Last Name:
67. First Name:
68. Middle Initial:
69. Date of Birth:
    Date of Birth:
71. Address:
72. City:
73. State:
75. State where ID/Driver's License Issued From:
77. Has this person been convicted of a felony under any state or federal law within the last five years?

    1. Yes
    2. No
79.  

    1. Check this box if you need to add another person who will be engaging in the commercial solicitation.
81. Last Name:
82. First Name:
83. Middle Initial:
84. Date of Birth:
    Date of Birth:
86. Address:
87. City:
88. State:
90. State where ID/Driver's License Issued From:
92. Has this person been convicted of a felony under any state or federal law within the last five years?

    1. Yes
    2. No
94.  

    1. Check this box if you need to add another person who will be engaging in the commercial solicitation.
96. Last Name:
97. First Name:
98. Middle Initial:
99. Date of Birth:
    Date of Birth:
101. Address:
102. City:
103. State:
105. State where ID/Driver's License Issued From:
107. Has this person been convicted of a felony under any state or federal law within the last five years?

     1. Yes
     2. No
109.  

     1. Check this box if you need to add another person who will be engaging in the commercial solicitation.
111. Last Name:
112. First Name:
113. Middle Initial:
114. Date of Birth:
     Date of Birth:
116. Address:
117. City:
118. State:
120. State where ID/Driver's License Issued From:
122. Has this person been convicted of a felony under any state or federal law within the last five years?

     1. Yes
     2. No
124.  

     1. Check this box if you need to add another person who will be engaging in the commercial solicitation.
126. Last Name:
127. First Name:
128. Middle Initial:
129. Date of Birth:
     Date of Birth:
131. Address:
132. City:
133. State:
135. State where ID/Driver's License Issued From:
137. Has this person been convicted of a felony under any state or federal law within the last five years?

     1. Yes
     2. No
139.  

     1. Check this box if you need to add another person who will be engaging in the commercial solicitation.
141. Last Name:
142. First Name:
143. Middle Initial:
144. Date of Birth:
     Date of Birth:
146. Address:
147. City:
148. State:
150. State where ID/Driver's License Issued From:
152. Has this person been convicted of a felony under any state or federal law within the last five years?

     1. Yes
     2. No
154.  

     1. Check this box if you need to add another person who will be engaging in the commercial solicitation.
156. Last Name:
157. First Name:
158. Middle Initial:
159. Date of Birth:
     Date of Birth:
161. Address:
162. City:
163. State:
165. State where ID/Driver's License Issued From:
167. Has this person been convicted of a felony under any state or federal law within the last five years?

     1. Yes
     2. No
169.  

     1. Check this box if you need to add another person who will be engaging in the commercial solicitation.
171. Last Name:
172. First Name:
173. Middle Initial:
174. Date of Birth:
     Date of Birth:
176. Address:
177. City:
178. State:
180. State where ID/Driver's License Issued From:
182. Has this person been convicted of a felony under any state or federal law within the last five years?

     1. Yes
     2. No
184.  

     1. Check this box if you need to add another person who will be engaging in the commercial solicitation.
186. Last Name:
187. First Name:
188. Middle Initial:
189. Date of Birth:
     Date of Birth:
191. Address:
192. City:
193. State:
195. State where ID/Driver's License Issued From:
197. Has this person been convicted of a felony under any state or federal law within the last five years?

     1. Yes
     2. No
199.  

     1. Check this box if you need to add another person who will be engaging in the commercial solicitation.
201. Last Name:
202. First Name:
203. Middle Initial:
204. Date of Birth:
     Date of Birth:
206. Address:
207. City:
208. State:
210. State where ID/Driver's License Issued From:
212. Has this person been convicted of a felony under any state or federal law within the last five years?

     1. Yes
     2. No
214.  

     1. Check this box if you need to add another person who will be engaging in the commercial solicitation.
216. Last Name:
217. First Name:
218. Middle Initial:
219. Date of Birth:
     Date of Birth:
221. Address:
222. City:
223. State:
225. State where ID/Driver's License Issued From:
227. Has this person been convicted of a felony under any state or federal law within the last five years?

     1. Yes
     2. No
229.  

     1. Check this box if you need to add another person who will be engaging in the commercial solicitation.
231. Last Name:
232. First Name:
233. Middle Initial:
234. Date of Birth:
     Date of Birth:
236. Address:
237. City:
238. State:
240. State where ID/Driver's License Issued From:
242. Has this person been convicted of a felony under any state or federal law within the last five years?

     1. Yes
     2. No
244.  

     1. Check this box if you need to add another person who will be engaging in the commercial solicitation.
246. Last Name:
247. First Name:
248. Middle Initial:
249. Date of Birth:
     Date of Birth:
251. Address:
252. City:
253. State:
255. State where ID/Driver's License Issued From:
257. Has this person been convicted of a felony under any state or federal law within the last five years?

     1. Yes
     2. No
259.  

     All organizations and individuals conducting solicitation shall conform to all regulations as listed in Wheaton Ordinance Chapter 46. The entire code is available on the city website (wheaton.il.us/605/City-Code-Ordinances). The following are highlights of the ordinance and are not verbatim. They are intended to supplement your review of the actual ordinance.

     • Commercial solicitation may commence on weekdays from 9:00 a.m. to sunset and on weekends from 10:00 a.m. to sunset.
     • Commercial solicitation is prohibited at, within, or upon all public ways.
     • Commercial solicitors should comply with any posted notices for no solicitation.
     • Commercial solicitors shall immediately and peacefully depart from a premise when requested by the occupant.
     • All solicitors shall have photo identification on himself or herself at all times while engaging in solicitation activity within the City.
     • It shall be unlawful for any person under the age of 14 to engage in solicitation activity without adult supervision. 
     • Commercial solicitation notifications are effective for 90 days from the date of submission.
Leave This Blank:


261. 1. Receive an email copy of this form.
262. Email address

     This field is not part of the form submission.

263. Submit

* indicates a required field