Information Request Form

2. First Name*
3. Last Name*
5. Address1*
7. Address2
9. City*
10. State or Province*
11. Country (If not USA)
13. Zip or Postal Code
14. Email Address
    Your email address will not be shared. Check the box to the right to be added to our monthly e-newsletter. Otherwise your email address will only be used to contact you regarding this information request.
15. E-Newsletter

    1. Yes, please add me to your e-newsletter

    Click here to be added to our monthly e-newsletter. Your email address will never be shared with anyone else.
17. How did you learn about Pontiac?

    1. Friend or Family
    2. Newspaper or Magazine
    3. Television
    4. Travel Web Site
18. When do you plan to visit us?

    1. Within 30 days
    2. Two or Three months from now
    3. 6 months to a year from now
    4. Next year or later
20. What we send.
    In the packet we will send you, one copy of each of these items will be included: 1) Illinois Route 66 Visitors Guide. 2) Pontiac Illinois Visitor Guide. 3) Downtown Pontiac Map with Attractions. 4) Pontiac Hotel Guide. 5) Pontiac Restaurant Guide. 6) Pontiac Museums Brochure. 7) Pontiac Mural Tour Brochure. 8) Abraham Lincoln Tour Brochure. 9) Pontiac Charm Trail Brochure.
21. Where we send.
    We will send a literature pack anywhere in the U.S.A. Unfortunately, mailing costs can be prohibitive to some parts of the world but we’d be happy to share an electronic version of our visitor information with a provided email address.
23. We try to fulfill all literature requests as quickly as possible. Please be patient.
Leave This Blank:


25. 1. Receive an email copy of this form.
26. Email address

    This field is not part of the form submission.

27. Submit

* indicates a required field