Customer Registration
Personal Information:
Please fill out the form completely.
All fields are required for registration.
Biller:
Please Select a Utility
Chilton Water Authority
City of Columbus
City of Lincoln
City of Piedmont
City of Riverton
Holley Navarre Water System
Walton Co. Water
Web ID:
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First Name:
Last Name:
Address1:
Address2:
City:
State:
AL
AK
AZ
AR
CA
CO
CT
DC
DE
FL
GA
HI
ID
IL
IN
IA
KS
KY
LA
ME
MD
MA
MI
MN
MS
MO
MT
NE
NV
NH
NJ
NM
NY
NC
ND
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VT
VA
WA
WV
WI
WY
Zip:
Phone:
(
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Email:
Please verify your e-mail address. Incorrect e-mail addresses may prevent you from being able to access your account or receive important notices.
Confirm Email:
Please send other information regarding this account.
Username:
(6 Character minimum)
Please verify your Username. You will be required to provide this username to access your account and billing information.
Create a Password:
(letters, numbers, underscore)
Confirm Password:
Select a Security Question:
Please select a question:
What is your mother's maiden name?
In what city were you born?
What is your pet's name?
What is your favorite team?
What is your favorite sport?
What is the name of your high school?
Security Answer:
Type the characters into Secret Text box that appear in the image above. If you are having trouble distinguishing the characters, refresh the page for a new image.
Secret Text:
Terms and Conditions:
Please read the Terms & Conditions by clicking below. It contains important information concerning the privacy and security of your information. You must agree to the Terms & Conditions to continue.
* Your personal information or e-mail address will NOT be sold or rented to third parties for marketing purposes without your permission.
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How to
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