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2. Sign up to receive notifications regarding delinquent bills, boil water advisory, and water outages.
4. E-Bill: (no paper bill)*

   1. Yes
   2. No
5. Receive Notifications by:*

   1. Text
   2. Phone
7. Account Number:*
9. Account Name:*
11. Service Address:*
13. E-mail Address:*
15. Cell Phone:*
17. Home Phone:
21. Connect with us!

    The City of Rosenberg has a new emergency notification system! Staying connected with the City is now as easy as texting a keyword to "888777" or by filling out the form below. Stay informed of trusted neighborhood public safety and community information. 

23. Check the box below for the types of alerts you'd like to recieve:

    1. RTOWN For City Related notifications.
    2. RFDALERTS For Fire related notifications.

    1. RPDALERTS For Police related notifications.
    2. REVENTS For City Special Event notifications.

    Your signature below signifies that you are allowing the City of Rosenberg to enter your information into the Emergency Alert System. Your information is safe, secure and never shared. This service is free. 

25. Electronic Signature Agreement*

    By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.

    1. I agree.
27. Electronic Signature*
28. Date:*
    Date:
Leave This Blank:


32. 1. Receive an email copy of this form.
33. Email address

    This field is not part of the form submission.

34. Submit

* indicates a required field