New User Registration / Account Activation

Service Request User Registration

Use this form to create an account if ... 1) You wish to report a concern or request services. AND 2) You do not have an account to pay city bills. NOTE: This account registration is for service requests only. Please use our Bill Pay portal to create an account to pay bills.

Name (Last First MI) *
Mailing Address Line 1 *
Mailing Address Line 2
Mailing Address Line 3
Mailing City/State *
Mailing Zip *
Primary Phone *	(10 digits; no special characters)	Ext

Email *
Verify Email *
User Name *
Password *	(6-character minimum; no spaces)
Verify Password *
Secret Question *
Secret Answer *
Marital Status

* = Required field