North Penn Water Authority

PLEASE TAKE A FEW MOMENTS TO READ, COMPLETE AND SUBMIT THIS FORM.

As detailed in the Water Currents newsletter, the Authority is planning to implement a system that provides the ability to communicate specific information by recorded voice message in both emergency and non-emergency situations to the phone number supplied. Relayed information examples include: system-wide emergency, localized water main break or a temporary interruption of service due to construction or repair work.

Please add North Penn Water Authority to the list of entities you provide with updated contact information as it changes. Only with your cooperation can we ensure you are contacted in a timely matter should the need arise.

Please return this pdf with your bill stub and payment, or if you prefer, you can submit the form below or call a NPWA customer service representative at (215) 855-3617.

Personal Information

Name*	Account Number*
Address (Physical only, no P.O. Boxes)
Street*	Apartment, Suite, or Unit Number
City*	State*	Zip*
E-mail*
*required fields

Contact Information

Preferred Phone Number* (Cell Phone or whichever number you can be contacted at most quickly to convey important information.)
Alternate Phone Number (Entering an Alternate Phone Number will cause BOTH numbers to be contacted in the event a call goes out for the address specified.)
*required field

For Hearing Impaired

Check here for Preferred phone with a hearing impaired TDD/TTY device.
Check here for Alternate phone with a hearing impaired TDD/TTY device.
TDD ONLY TDD/TTY - Check TDD ONLY if you are hearing impaired and would like tone delivery of emergency messages - messages delivered to phone numbers marked TDD will ONLY be delivered in TDD/TTY format.