City of Hillsboro
Application for Canvasser’s License
CANVASSER. Any person who obtains or seeks to obtain or influences the opinions of the residents of the city by traveling door to door either by foot, automobile, truck, or other type of conveyance upon the private residences, including any house, apartment, or other dwelling in the city but does not obtain or seek to obtain funds for any cause whatsoever.
Name
Address
Height Height Color of Eyes Hair Color
Do you wear glasses? Do you have a mustache? Are you a citizen of the U.S.?
Make of car Year Type
Have you ever been convicted of an offense other than a minor traffic violation? If so, give dates.
Are you addicted to narcotics or alcohol?
Have you ever been licensed to solicit anywhere in. Highland County, Ohio? If yes, give dates and municipality names.
Have you been refused a license to canvass? If yes, give municipalities name and dates.
Have you ever had a license revoked? If yes, give dates and issuing authorities’ name.
ORGANIZATION INFORMATION
Name of Organization
Address
Phone
Explain the nature of your business.
Dates/Times/Locations where canvassing is to be performed:
I DO SOLEMNLY SWEAR THAT THE ANSWERS AS GIVEN HEREIN HAVE BEEN EXAMINED BY ME AND TO THE BEST OF MY KNOWLEDGE ARE TRUE, CORRECT, AND COMPLETE.
Applicant Signature Date
OFFICE USE Approved Not Approved
Date application was received
License denied? If yes, explain why.
Chief of Police Safety Service Director
(Ord. 2020-16, passed 12-14-2020)