WIFR Closings Inclusion Request Form

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***ATTENTION***
THIS FORM DOES NOT ADD YOU TO THE CURRENT CLOSING LIST
 

For Immediate Closings Call 815-987-5330

Please completely fill out this form to request the addition
of your organization
to the WIFR automated Closings system.
After we have confirmed your information we will send
your login and password information within 48 hours.

* If You Already Have A Login and Password Click Here *
1.What Type of Organization do you represent?*
Business
Child Care
Church
Event
Government
Medical
Organization
Other
School
Small Business
Sports
2.Official Name of Organization:
*
3.Mailing Address:
Street Line 1*
Street Line 2
City*
State*
Zip Code*
4.Contact Peson:
*
5.Title of Contact Person:
*
6.Phone Number (Numbers only, No dashes):
*
7.E-mail Address:
*
8.Size Of Organization:*
1 - 10
10 - 50
50 - 100
100+
9.Please enter your date of birth.
Month* Day* Year*

10.Terms and Conditions
I have read, understand, and agree to the Website usage agreement and privacy policy.
* represents required fields

Thank you for filling out our Closings Inclusion Request Form we will be contacting you to confirm that all information is correct. After we have confirmed your information we will send your login and password information within 48 hours. If you need to be included before you are added to our automated system please call 815-987-5330.