Service Provider Directory Contact Information Form (Web Form)
This form should be completed by companies that are interested in being added to the Natural Gas STAR Service Provider Directory.
Field Name |
Data Type |
Required |
Notes |
First Name |
Single Line of Text |
Yes |
First name of company point of contact |
Last Name |
Single Line of Text |
Yes |
Last name of company point of contact |
Company/Org Name |
Single Line of Text |
Yes |
|
Street Address |
Single Line of Text |
Yes |
|
City |
Single Line of Text |
Yes |
|
State |
Single Line of Text |
Yes |
|
Zip/Postal Code |
Single Line of Text |
Yes |
|
Country |
Dropdown List |
Yes |
|
Email Address |
Single Line of Text |
Yes |
Email address for company contact |
Phone Number |
Single Line of Text |
Yes |
Phone number for company contact |
Fax Number |
Single Line of Text |
No |
Fax number for company contact |
Website Address |
Single Line of Text |
No |
Company/org website |
Services Description |
Multiple Lines of Text |
Yes |
|
Service Category |
Multiselect |
Yes |
Identify applicable service categories |
Service Category Other |
Single Line of Text |
No |
Identify service categories not listed |
Emission Sources |
Multiselect |
Yes |
Equipment/Technology to Mitigate Methane Emissions From: |
Emission Sources Other |
Single Line of Text |
No |
Identify emission sources not listed |
Technology |
Multiselect |
No |
Identify applicable technologies |
Technology Other |
Single Line of Text |
No |
Identify technologies not listed |
Applicable Segments |
Multiselect |
Yes |
Identify applicable sector(s) |
Would You Like to Receive Email Updates? |
Yes/No |
Yes |
|
NOTE: EPA created the Service Provider Directory to share information on service and technology providers that can facilitate methane emission reduction activities, not to endorse particular companies or products. Providing contact information and links to non-EPA websites does not constitute an endorsement by EPA or any of its employees.
EPA Form Number 5900-502
File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
Author | Lau, Patrick |
File Modified | 0000-00-00 |
File Created | 2021-07-05 |