MUD MEMBERSHIP INFORMATION FORM

The information described below will be used by CCFCC to communicate internally with each of our members. We rely on e-mail and encourage all members to make arrangements for this communications channel to be available for this purpose. Most members have arranged for more than one of their representatives to receive e-mail correspondence. Please refer to the By-Laws for delegate voting rights.

For information on completing this form, please call 281.469.5161 or send an email with your questions.

 

YOUR ORGANIZATION
Name (as it appears on legal documents)
YOUR DELEGATES & ALTERNATE
Delegate Name
Delegate Title
Mailing Address
City
State
Zip
Telephone (Home)
Telephone (Office)
Fax (if available)
E-mail address
Alternate Name
Alternate Title
Alternate Mailing Address
Alternate City
Alternate State
Alternate Zip
Alternate Telephone (Home)
Alternate Telephone (Office)
Alternate Fax (if available)
Alternate E-mail address
SUBDIVISIONS IN YOUR DISTRICT
Please list all subdivisions in your district.
Number of water connections in your district.
Single Family Homes
Apartment Units
Businesses
If any subdivisions are still in the developer/builder phase, what is the approximate planned total number of additional homes for which connections have not been made.
My area has experienced flooding in past years (homes and/or streets or adjacent primary access roads.
Prepared by
Your Phone Number

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