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Town of Summerhill Business Request to List Your Business on the Website Name of the Business Business Address Product(s) or Service(s) Provided (list all) 1. 2. 3. Phone Number Email Address or Website (List both is appropriate) Hours Available or Open for Business 4. 5. If you have any questions, please contact Charles Ripley via email Completed form can be dropped off, faxed or mailed to the Town of Summerhill Town Clerk (Carol Chase) Fax: 497-3475 Address: 13606 State Route 90, Locke, NY 13092 Business Owner(s)' Name Request Approved: Charles Ripley, Town of Summerhill Supervisor Date