In the event of an emergency, such as a water/sewer main break or water contamination situation, we need to be able to reach you quickly. The District will never sell or otherwise distribute this information to any other parties. This information is sent directly to our customer service staff, and will only be used for contacting you regarding District business matters.
As it appears on your statement.
(This is the number we will use in case of an emergency)
MWWD never sells or distributes any of your information, including email addresses, to anyone. Your email address is needed strictly for purposes of emergency communication with the District.
By checking the "I agree" box below, you agree and acknowledge that 1) this form will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.
I affirm that the above information is true & correct.
This field is not part of the form submission.
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