Edmond Electric Touch-a-Truck Sign-Up

2. Company/Organization*
4. Contact Name*
6. Address*
8. City*
9. State*
10. Zip Code*
12. Primary Phone*
    Number should be for the person who will be attending the event. Will only be used in emergency/urgent situations.
13. Alternate Phone
15. Email *
17. Number of Vehicles*
18. Type of Vehicle(s)*
20. Special Requests/Needs*
    (i.e. emergency vehicles)
22. Certificate of Insurance*

    Please upload your certificate of insurance with the City of Edmond listed as an additional insured. 

24. 
25. 
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27. 1. Receive an email copy of this form.
28. Email address

    This field is not part of the form submission.

29. Submit

* indicates a required field