Laserfiche WebLink
<br /> <br />Utility Services <br /> <br />Water & Wastewater <br /> <br />City of Fort Collins <br /> <br />WATER USERFSEARCH STUDY <br />ACCEPTANCE FORM <br /> <br />I have read the research study guidelines and participant obligations provided to me, and agree <br />to adhere to them. In compensation for doing so, I will receive $25 as a Group 1 participant <br />or $100 as a Group 2 participant. I also agree to notify Jim Clark at the Water Utility (221- <br />6681) if! am going to move from my residence being studied before November 1, 1994. <br /> <br />o I will take part as a Group I participant. <br /> <br />o I will take part as a Group 2 participant. <br /> <br />Name (print): <br /> <br />Address: . <br /> <br />phone (home): <br /> <br />phone (work): <br /> <br />Signature: <br /> <br />Date: <br /> <br />Water Utility Copy: Please sign and mail to: Jim Clark, Water Utility, P.O. Box 580, Fort <br />Collins, CO 80522. <br /> <br />p.o. Box 580 . Fort Collins, CO 80522-0580 . (303) 221-6681 <br />