KY Green Update Form

KY Green System Permissions (Please Type) Activity Number WX LH Agency Name Agency Address Agency Phone Number User 1 First & Last Name User 1 E-Mail Address System Permission* User Administrator User 2 First & Last Name User 2 E-Mail Address System Permission* User Administrator User 3 First & Last Name User 3 E-Mail Address System Permission* User Administrator User 4 First & Last Name User 4 E-Mail Address System Permission* User Administrator User 5 First & Last Name User 5 E-Mail Address System Permission* User Administrator Executive Director Name ED E-Mail Address Is ED recorded above as a User or Administrator? Yes No

* System Permission: System User – Can make adjustments in KY Green. System Administrator – Can make adjustments and submit draws in KY Green.

Counties Served Select all that apply. Adair Allen Anderson Ballard Barren Bath

Bell Boone Bourbon Boyd Boyle Bracken

Breathitt Breckinridge Bullitt Butler Caldwell Calloway

Campbell Carlisle Carroll Carter Casey Christian

Clark Clay Clinton Crittenden Cumberland Daviess

Edmonson Elliott Estill Fayette Fleming Floyd

Franklin Fulton Gallatin Garrard Grant Graves

Grayson Green Greenup Hancock Hardin Harlan

Harrison Hart Henderson Henry Hickman Hopkins

Jackson Jefferson Jessamine Johnson Kenton Knott Knox LaRue Laurel Lawrence Lee Leslie

Letcher Lewis Lincoln Livingston Logan Lyon

McCracken McCreary McLean Madison Magoffin Marion

Marshall Martin Mason Meade Menifee Mercer

Metcalfe Monroe Montgomery Morgan Muhlenberg Nelson

Nicholas Ohio Oldham Owen Owsley Pendleton

Perry Pike Powell Pulaski Robertson Rockcastle

Rowan Russell Scott Shelby Simpson Spencer

Taylor Todd Trigg Trimble Union Warren

Washington Wayne Webster Whitley Wolfe Woodford

RETURN TO KY GREEN SYSTEM ADMINISTRATOR: [email protected]