Form Center

2. Thank you for reaching out to the Bremerton City Council.

   Please fill out the form, below, to send a message to the City Council office. If you would like to email or call a Councilmember directly, please visit their Council District webpage for that information.

   Request a City service, or report an issue such as fixing a streetlight, filling a pothole, or reporting garbage and debris, through Bremerton1.

   This feedback will be sent directly to the Bremerton City Council Office.

4. First Name*
5. Last Name*
7. Address*
9. City*
10. State*
11. Zip*
13. Email Address*
14. Phone Number
16. Councilmember to Contact*
    -- Select One --District 1 - Jennifer ChamberlinDistrict 2 - Denise FreyDistrict 3 - Christy CammarataDistrict 4 - Jane RebelowskiDistrict 5 - Michael GoodnowDistrict 6 - Anna MocklerDistrict 7 - Rick Tift
18. Message Topic*
    -- Select One --Schedule a meeting with a CouncilmemberSchedule a speaking engagementPublic Works – roadsPublic Works – utilitiesPublic Works – garbage/debrisDCD – permittingCode ComplianceParksHousing & HomelessOther
20. Your message to elected leader(s)*

    Please provide detailed information to assist the City Council in understanding your concern. If you are requesting a meeting, please include the topic(s) you would like to discuss in the meeting. Any relevant information you can provide, including past contacts with Bremerton1, will help us better assist you.

22. Include other Councilmembers in your message

    (Optional) Select additional recipients for this message

    1. District 1 - Jennifer Chamberlin
    2. District 2 - Denise Frey
    3. District 3 - Christy Cammarata
    4. District 4 - Jane Rebelowski

    1. District 5 - Michael Goodnow
    2. District 6 - Anna Mockler
    3. District 7 - Rick Tift
24. How do you prefer to be contacted? *

    You may select multiple options

    1. Email

    1. Phone

    1. No Reply Necessary
26. Optional File Upload
Leave This Blank:


28. 1. Receive an email copy of this form.
29. Email address

    This field is not part of the form submission.

30. Submit

* indicates a required field