138 West Bishop Street,  Bellefonte, PA 16823
800-653-PRWA, 814-353-9302, fax 814-353-9341, prwa@prwa.com 
Member of National Rural Water Association
SYSTEM - ONLINE APPLICATION
Please complete the following form.  Required fields are in Purple. 
Number of Connections:
System Type:
Number of Connections:
Number of Taps:
Population Served:
System Name:
Contact Person:
Address1:
Address2:
City:
State:
Zip Code:
County:
Phone:
Fax:
Email:
Website:
Federal Rep District:
State Senatorial District:
State Rep District:
Mayor / Council President:
System Plant Description:
PUC Regulated:
Water Source:
Water Source Metered:
Customers Metered:
Average Gal/Day Usage:
Type of Treatment Plant:
We have a Wellhead Plan:
Primary Operator:
Secondary Operator:
Bookkeeper / Clerk:
Engineer:
Solicitor:
Governing Body Meets:
Type of Government:
General comments:
(Please help me with
sponsoring a training,
attending a training,
or another concern)

You will be invoiced as soon as we receive your request.
 

 

Pennsylvania Rural Water Association, 138 West Bishop Street, Bellefonte, PA 16823
800-653-PRWA, 814-353-9302, Fax 814-353-9341, www.prwa.com, prwa@prwa.com