Friday, July 30, 2010    
UPDATE MEMBER INFORMATION FORM  UPDATE MEMBER INFORMATION FORM  

Use this form to register as a new member or to update your existing contact personnel and communication preferences.
YOUR INFORMATION
NAME:
TITLE:
PHONE:  (please include area code)
FAX:  (please include area code)
  EMAIL:
CALL DIRECTING CODE(S): (if applicable)
COMPANY'S INFORMATION
COMPANY'S LEGAL NAME:
STATE OF INCORPORATION:
WV NAME (IF DIFFERENT):
BUSINESS ADDRESS OF HEADQUARTERS:
CITY:    ZIPCODE:  
COMPANY'S BILLING INFORMATION
NAME OF PERSON TO BILL:
TITLE:
PHONE:  (please include area code)
FAX:  (please include area code)
  EMAIL:
ADDRESS:

   ZIPCODE:     
CITY:
COMPANY'S ONE CALL CORRESPONDENCE REPRESENTATIVE
NAME:
TITLE:
PHONE:  (please include area code)
FAX:  (please include area code)
  EMAIL:
ADDRESS:

   ZIPCODE:    
CITY:
ALTERNATE CORRESPONDENCE REPRESENTATIVE  (optional)
NAME:
TITLE:
PHONE:  (please include area code)
FAX:  (please include area code)
  EMAIL:
ADDRESS:

   ZIPCODE:    
CITY:
MESSAGE RECEIVER SITE/LOCATION INFORMATION
Note: If your company will be receiving tickets at more than one location, then this form must be submitted for each receiver location.
CONTACT:
PHONE:  (please include area code)
FAX:  (please include area code)
  EMAIL:
ADDRESS:
CITY:    ZIPCODE:  
PRIMARY RECEIVING DEVICE:
RECEIVING EMAIL OR PHONE:

WORKING HOURS & HOLIDAYS
NORMAL WORKING HOURS:   to   
WORK WEEK:
The following holiday information is needed by the Call Center in order to know when your receiving location is operational. If this list changes or an office closes early the day before the holiday, please make such an indication below or notify the Customer Service department at 1-888-987-3742 when they are leaving. If the office will be closed for more than one consecutive day, please list a range in the date(s) field.
HOLIDAY FULL DAY HALF DAY DATE(S)
NEW YEARS DAY
MARTIN LUTHER KING DAY
LINCOLNS BIRTHDAY
PRESIDENTS DAY
WASHINGTONS BIRTHDAY
GOOD FRIDAY
MEMORIAL DAY
INDEPENDENCE DAY
LABOR DAY
COLUMBUS DAY
ELECTION DAY
VETERANS DAY
THANKSGIVING DAY
THANKSGIVING FRIDAY
CHRISTMAS EVE
CHRISTMAS DAY
NEW YEARS EVE
OTHER:

TELEPHONE NOTIFICATION INFORMATION - DURING WORK HOURS
Do you wish to receive a voice message from the Call Center (in addition to the regular message transmission) for the following? Please note that this incurs an extra charge.
EMERGENCY IF YES, REFERRAL PHONE #:   (please include area code)
Emergency = when the caller states that the work to be performed is of an emergency nature.
DIG UP IF YES, REFERRAL PHONE #:   (please include area code)
Dig Up = when the caller states that a line has been exposed or damaged.
TELEPHONE NOTIFICATION INFORMATION - AFTER WORK HOURS
Do you wish to receive a voice message from the Call Center (in addition to the regular message transmission) for the following? Please note that this incurs an extra charge.
EMERGENCY IF YES, REFERRAL PHONE #:   (please include area code)
Emergency = when the caller states that the work to be performed is of an emergency nature.
DIG UP IF YES, REFERRAL PHONE #:   (please include area code)
Dig Up = when the caller states that a line has been exposed or damaged.
PRIORITY / SHORT NOTICE IF YES, REFERRAL PHONE #:   (please include area code)
Priority/Short Notice = when the caller gives 4 hours or less prior notice of digging.

TYPE OF UNDERGROUND FACILITIES THAT YOU ARE PROTECTING












 
WOULD YOU LIKE US TO LIST YOUR COMPANY NAME ON THE MUWV WEBSITE?
WOULD YOU LIKE YOUR COMPANY'S WEBSITE LINKED ON THE MUWV WEBSITE?
IF YES, ENTER WEBSITE URL:
DO YOU REQUEST AN AUDIT?
ADDITIONAL INSTRUCTIONS
 
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