Request a site visit from our Circuit Riders

Name *

First

Last

Email *

Phone Number *

Organization Name (If none, just put N/A) *

Who owns the Building? Is it leased? *

Organization/Owner Affiliation *

Are you authorized to engage with PCT on your organization’s or the owner’s behalf?

Address *

Address Line 1

City

State

This needs to be an exact address of the property.

Please describe the issue you would like to discuss with a Circuit Rider *

Have you had contact with Preservation CT or a Circuit Rider in the past? *

Yes
No

Please tell us which Circuit Rider:

Have you had contact with the State Historic Preservation Office (SHPO)? Please include all details. *

Please request 3-4 dates/times that work for you (M-F, 9:00AM-4:00PM)

Please DO NOT request a slot within 7 days of today’s date. Please ONLY request a Site visit MONDAY-FRIDAY between the times of 9:00AM-4:00PM. If this is an emergency request, please contact mforino@preservationct.org

Preferred Date/Time *

Date

Time

Preferred Date/Time 2 *

Date

Time

Preferred Date/Time 3 *

Date

Time

Preferred Date/Time 4

Date

Time

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Request a site visit from our Circuit Riders

Please request 3-4 dates/times that work for you (M-F, 9:00AM-4:00PM)

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