5900-502 Service Provider Directory Contact Information Form

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