EMWD Customer Communication Preferences Form

EMWD Customer Communications Preferences Form

This form is used to update customer communication preferences.
Name

First NameLast Name
Account Number
Enter your 9 digit account number using the following format: 123456789.
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email
example@example.com
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
EMWD reaches out to customers for a variety of reasons. For each of the following, please indicate the best way for EMWD to communicate with you on that topic.
Your regular water bill:
A water advisory notice:
An in-person meeting where water issues will be discussed:
Planned service disruptions for maintenance:
Emergency service disruptions for repairs:
Opportunities to quality for water-savings rebates:
Information about water conservation programs:
EMWD allows customers to opt in to receive text message updates. Do you want to opt in to receive text messages?
Text Message opt in phone number
Please enter a valid phone number.Format: (000) 000-0000.
EMWD allows customers to opt in to receive email message updates. Do you want to opt in to receive email messages?
EMWD provides material in both English and Spanish. What is your language of preference?

Other
*Other language preference
Please indicate other language preference
Date

MonthDayYear
Please verify that you are human
Should be Empty:

EMWD Customer Communications Preferences Form