Please Take Five Minutes to Tell Us What You Need!

Happy World Water Day! This World Water Day, we would really like to find out more about you and what you need to know. All answers are optional - so complete as much or as little of this form as you would like (if you would like us to follow up with you please ensure that you have provided us with your email address).

Name

First Name

Last Name

Email Address

What is the name of the community in which you live?

What Topics, Related to Water, Would You Like to Learn More About?

Do you think that your tap water is safe to drink?

Do you know where your tap water comes from?

Have you donated to Safe Drinking Water Foundation?

If you have donated to Safe Drinking Water Foundation, thank you so much! What made you decide to donate?

If you have not donated to Safe Drinking Water Foundation, why haven't you? Have you considered making a donation?

Do you have any feedback for us regarding our website?

Please note: If you would like us to follow-up with you, pleasure ensure that you have provided your email address in this form.

Do you have any feedback for us regarding our educational programs?

Please note: If you would like us to follow-up with you, pleasure ensure that you have provided your email address in this form.

Do you have any other feedback, comments, questions, or concerns that you would like to share with us?

Please note: If you would like us to follow-up with you, pleasure ensure that you have provided your email address in this form.

Would you appreciate a follow-up email message?

Please make sure that you have provided your email address in this form if you would like us to contact you.

Yes

Please Take Five Minutes to Tell Us What You Need!

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