Town of Firestone Rebate Program Survey
Exit this survey 

1.

 
Please take a few minutes to complete this short survey as part of the rebate program application. This survey is the last step in the application process; once finished and approved the Town of Firestone will issue your rebate. Please allow 6 to 8 week for the rebate program process.
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1. Applicants Information:
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2. Water Account Number:
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3. What type of rebate have you applied for?
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4. Why did you decided to install a new High-Efficiency Toilet or Washing Machine?
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5. Please answer yes or no pertaining only to the type of rebate you have applied for:
YesNo
Compared to your old toilet, does your new toilet require double flushing?
Compared to your old washing machine, does your new washing machine allow you to wash more clothes per load?
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6. Please answer yes or no pertaining only to the type of rebate you have applied for:
Very SatisfiedSomewhat SatisfiedNeither Satisfied nor DissatisfiedSomewhat DissatisfiedVery Dissatisfied
How satisfied are you with the amount of rebate for the High-Efficiency Toilets?
How satisfied are you with the amount of rebate for the High-Efficiency Washing Machine?
7. Comments about the rebate program: