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Town of Whitchurch Stouffville Bulk Water Application

Please fill out this application create a new bulk water account.

I/we hereby apply for permission to use the Bulk Water Station Located at 120 Ringwood Dr. I/we accept full responsibility for the safe keeping of the Operator Number provided and agree to pay all charges incurred by that Operator Number.

I/we understand that payment is required prior to use of the Bulk Water Station and account(s) must be kepy with a balance to continue use.

The vehicles listed are currently in service and I/we agree to advise the Town of Whitchurch-Stouffville of any changes to our fleet compliment.

I have read and agree to the terms and conditions listed above

I disagree

I agree

Personal information contained in this form is collected under the authority of the Town and will be used for the purpose of applying for a bulk water account. Questions about this collection should be directed to the Manager of Customer Service, Town of Whitchurch-Stouffville, 111 Sandiford Drive, Stouffville, ON L4A 0Z8 (905) 640-1910 or 1-855-642-8697.