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Update Current Information

Already in our system but have new contact information? Please submit this form and we will update our records. Changes may include: phone, email, address, position, etc.

Contact Information

Name

First Name

Last Name

Borough, Municipality, or Township (elected officials only)

If you are an elected official, tell us which Borough, Municipality, or Township you reside in.

Position Title

Email

Be sure to provide us with the most current information!

Verify Email

Email Type

Home

Work

Borough/Municipality

Address

Address Line 1

Address Line 2

City

City

State

State/Province

ZIP/Postal Code

Country

Address Type

Home

Work

Borough/Municipality

Phone 1

Phone Type

Home

Cell

Work

Borough/Municipality

Phone 2

Phone 2 Type

Home

Cell

Work

Borough/Municipality

Use this space to provide any additional information you feel is relevant.