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WA Contractors List

Weed Abatement Contractors Interest Form

Weed Abatement Contractors

This form is for companies wishing to advertise their name and contact information on the City of Ashland's Weed Abatement webpage for city customers seeking abatement services.

If you are interested in being listed on the City of Ashland's weed abatement website as a weed abatement contractor, please fill out this form completely and accurately. It is required for all listed businesses to hold a current business license with the City of Ashland. If you have questions filling out this form, you may call the Weed Abatement Coordinator at 541-552-2246 during normal business hours or leave a message and they will return your call the next business day.

COMPANY INFORMATION

* Company Name:

* Contact Name:

* Street Address:

* City:

* State:

* Zipcode:

* Phone Number (no dashes):

Alternate Phone Number (no dashes):

Email:

Company Website Address (if any):

BUSINESS LICENSE INFORMATION

* City of Ashland Business License Number:

* Expiration Date:

Your Company Name and phone number will automatically be listed on the webpage. Please select any ADDITIONAL contact info you would also like displayed:

Contact Name

Email Address

Website Address

FORM COMPLETED BY

* Full Name:

* SIGNATURE: By typing your full name here, you are stating that all information on this form is true and correct to the best of your knowledge.

* Date: