Service Contract Request Form
For those with a lot at one of the campgrounds we service, please complete this form to request contract service for the current season. A new contract is required each season to ensure we have the correct information for each lot requiring service.
Which campground is your lot at? *
Billing Name *
Enter the billing name as it should appear on the account
Your answer
Billing Street *
Enter the address or PO Box that we should send snail mail to
Your answer
Billing City *
Enter the city for the billing address we should send snail mail to
Your answer
Billing State *
Enter the state for the billing address we should send snail mail to
Your answer
Billing ZIP *
Enter the ZIP Code for the billing address we should send snail mail to
Your answer
Phone Number *
Enter the best contact phone number in case we need to call you
Your answer
Email Address
Enter the best contact email. This is our preferred method of contact.
Your answer
Preferred contact method *
If we need to contact you, we prefer email. Please select the way you prefer we contact you.
Preferred invoice format *
Select which type of invoice you would like to receive.
Lot Number *
Enter your lot number here. If you would like service for multiple lots, you can include them all here, separated by a comma. Billing is by lot, so if you lease or own multiple lots, but only need service on one, only include the lot you want service for.
Your answer
Select the service you would like *
Changes can be made to service during the season. Please remember that changes made by Monday will be effective that week. Changes made after Monday may not take affect until the following week.
Select the months you would like service
If you would like to start or stop service part way through a month, please select the months you want full service, then enter the odd start/end date under "Other". The most common service period is the beginning of April through the end of October, however we do offer service year-round for those who completed contracts for the season.
Comments
Enter comments here, such as anything special we need to know about your setup so we can complete service in a timely manner.
Your answer
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This form was created inside of I M Pumper Inc.