Tri-Community Public Works Authority is a not-for-profit public trust.

The beneficiaries of the Trust are your local communities of Watts, Colcord and West Siloam Springs. The purpose of the trust is to bring natural gas into the area to provide a cheaper, cleaner and safer source for heating fuel.

The natural gas distribution system will aid in economic and industrial development for the local area.

This survey is for the purpose of identifying interest in natural gas.

Do you presently use  (check any that apply)  as a heating source?

Propane           Electricity            Fuel Oil             Wood

If natural gas was provided to you at a cheaper rate then you have been paying for your heating fuel and there was no hook up fee, would you use natural gas?

Yes              No

Name of potential customer       

Phone No.

 Address

 
 Street Number and Name


 Apartment or Suite Number If Applicable


 City and State


 Zip Code

Email Address

Number in family:   

Any Indian Cards?     Yes          No 

Date:   (Example:  02/06/2004)

Written or (Online Typed) Signature 

Note:  This information will remain confidential and will not be shared with anyone.  It will be used only to establish a clear idea of the interest in bringing natural gas to your area.