New Customer Sign-Up

New Customer Sign-Up

    Services Requested*

    Occupant Information
    Is your Mailing Address the same as the Service Address?

    Would you like to add a Co-Occupant?

    Co-Occupant Information

    E-Billing Information
    I hereby authorize the City of Goodland to E-Mail my utility bill for the above listed address to my personal E-Mail address as listed above.
    With signing this agreement I understand that I will no longer receive a utility bill in the mail from the City of Goodland.

    Are you interested in Automatic Bank Withdrawl?

    I, the above named applicant, hereby authorize the City of Goodland, to submit my monthly utility billing to the named establishments for automatic withdrawal and understand that at any time I may cancel this agreement upon notification to the City of Goodland.

    Application for Automatic Bank Withdrawl

    Upload a copy of a voided check or deposit slip. (PNG and JPG allowed, 8mb limit)