Staff Form – Lead EntryNorth DurhamPlease Complete The Following: Source* Phone - Lamplight (whisper) Phone (non-whisper) Walk-in Referral Service Tech Email EcoWater FacebookTech Name*Referrer Name*Are You a Current Customer?* Current or Past North Durham EcoWater Customer New to North Durham EcoWaterAccount NumberSales lead or Service lead?* Sales ServiceName* First Last Business Name (optional)Address* Street Address City Postal Code Phone*Email* Interested In: Free Water Testing Water Softener Drinking Water System Whole Home Filtration Bottlefree Water Cooler Commercial/Industrial Water Treatment UV Disinfection Treating Smells/Colours Tanks/Pumps OtherWater Type: Municipal Water Well Water Lake Water Community WellAdditional NotesEmailThis field is for validation purposes and should be left unchanged. New Form