Membership Application Name of Applicant #1:(Required) First Last Email address: Home phone#:Cell Phone#:(Required)Employer:Position:Work Phone#:Name of Applicant #2: (If Applicable) First Last Email address: Home phone#:Cell Phone#:Employer:Position:Work Phone#:Service Addres:(Required) Street Address City State / Province / Region ZIP / Postal Code Water Use Type:(Required) Single-Family Residence Multi-Family Units Church Commercial Other If Other, please explain:Mailing Address (if different than Service Address): Street Address City State / Province / Region ZIP / Postal Code Last Address: Street Address City State / Province / Region ZIP / Postal Code 1. Are you the legal landowner of the property where water service will be provided?(Required) Yes No 2. Is this property going to be a rental property?(Required) Yes No 3. Have you been a member of EHU Water in the past?(Required) Yes No If Yes, please give dates and name the account was under.4. Name of the Utility Company that provided you water at your previous residence?5. Will there be a swimming pool on the property?(Required) Yes No 6. Is this a new construction or a home already in existence?(Required) New Construction Home Already in Existence I/we hereby requests service from Eastern Heights Utilities, Inc. and herewith make application for membership in said corporation. I/we agree to be bound by the Articles of the Incorporation, the Bylaws and Amendments thereto, and such rules and regulations as adopted by the Board of Directors. All information and statements made in this document are true and accurate to the best of my knowledge. If information is found to be inaccurate I/we, agree to provide the correct information and pay any additional fees, which may be required. Inaccurate information may cause water service to be disconnected or denied.(Required) I agree Date(Required) MM slash DD slash YYYY Signature of Applicant #1(Required)Signature of Applicant #2Applicant #1 Printed Name(Required)Applicant #2 Printed Name
