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Water Conservation Workshops <br />Participant Survey <br />Information Regarding Potential Needs for Technical and Financial Assistance <br />Contact Information (to help us keep you current) <br />Name 1 tC, L Y � � 6 eU6` (. E � <br />n <br />Organization - rYA/VS rode lMA Dom �( � <br />Mail Address t3 4'rA 57 '2- -CI& c /q/-T ( <br />�� 3 <br />E -Mail ® r <br />Organizational Needs (check box the best represents your situation I being substantial need, 5 being no <br />need) <br />3 <br />5 <br />Information on Water Conservation Planning <br />❑ <br />❑ <br />❑ <br />❑ <br />Information on Water Conservation Measures and Programs <br />❑ <br />❑ <br />❑ <br />❑ <br />Technical Support for Water Conservation Plannino <br />General Planning <br />' <br />❑ <br />❑ <br />❑ <br />❑ <br />Water System Mapping and Evaluations <br />❑ <br />❑ <br />❑ <br />❑ <br /># <br />❑ <br />❑ <br />❑ <br />❑ <br />Applicability of Specific Measures and Programs <br />Financial Analyses (i.e., pricing water) <br />❑ <br />❑ <br />❑ <br />/� <br />❑ <br />Monitoring and Measuring <br />❑ <br />El <br />El <br />11 <br />Updates and Revisions <br />❑ <br />El <br />El <br />❑ <br />Technical Support for Water Conservation Implementation_ <br />Communications /Publicity /Messaging <br />❑ <br />❑ <br />❑ <br />❑ <br />Education <br />❑ <br />❑ <br />❑ <br />❑ <br />Outdoor Use <br />Indoor Use <br />❑ <br />❑ <br />❑ <br />❑ <br />❑ <br />❑ <br />❑ <br />❑ <br />Leak Detection and Repair <br />❑ <br />❑ <br />❑ <br />❑ <br />Alternative Water Supplies <br />El <br />E] <br />❑ <br />El <br />Monitoring and Measuring <br />❑ <br />❑ <br />❑ <br />❑ <br />Financial Support for Water Conservation Planning <br />❑ <br />❑ <br />❑ <br />❑ <br />Financial Support for Water Conservation Implementation <br />❑ <br />❑ <br />❑ <br />13 <br />