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2. Date of Request*
4. Service Address*
6. First Name*
7. Last Name*
9. Email Address*
10. Phone Number*
12. City*
13. Province*
14. Postal Code*
16. Type*

    1. Residential
    2. Business
18. Fee: $136.50 (includes GST) Can be paid via cheque mailed to Box 1030 Slave Lake AB T0G 2A0 or online banking Slave Lake (Town)-AR using account number ZZZ002

    Please note you can setup online banking through bill payments, we do not accept e-transfer. If you are having trouble setting up the payee, please contact your banking institution and they can add this to your online banking or direct you on how we are setup in their system.

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