Utility Council National Benchmarking Registration

Please use the form below to register your site. If you are registering for more than one site please complete a separate form for each site.

Facility Issues will E-mail your site submittal code, to be used in submitting your site data, to the E-mail address provided with your registration.

First Name:
Last Name:
Company:
Address:
City, State Zipcode:
Country:
Phone number with area code:
Fax number with area code:
Email:

Fees:

The cost to participate in the Utility Council Benchmarking survey (base services) is $1875 per site. Additional sites from the same company /subsidiary are $1095 each. Payment is due within 45 days of your sign up. Please indicate your method of payment (select one):

Number of benchmarking sites:    
Enter 1 if you will be submitting one set of data.

If you chose "Credit Card" follow the instructions below before clicking the submit button.

Occupancy Surveys:
Do you want Facility Issues to create a "Customer Satisfaction Survey" for your site, analyze the data, and include the summarized data responses in the final Benchmarking Survey? The cost per site is an additional $600.

Number of occupancy survey sites:    
Enter 0 if you do not need an occupancy survey
Enter 1 if you will be submitting one set of data.

If you chose "Credit Card" follow the instructions below before clicking the submit button.

NOTE FOR CREDIT CARD PAYMENTS ONLY:

If you are making payment by credit card:

  1. Print a copy of this form now - before clicking the submit button

  2. Write in the following information

  3. Fax to: 1-928-213-9763

Credit card number: __________________________________________________

Expiration Date: ____ Month ____ Year

Name on card: ______________________________________________________

Total amount to be charged: $__________ (US)

Email address for receipt (if different than the above registration email address):

__________________________________________________________________

Facility Issues ©  2010

Voice: (928) 213-9767
Fax: (928) 213-9763

Mailing Address: PO Box 1447, Flagstaff, AZ 86002 --1447 USA