Collaborator Information

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* 1. Full Name:

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* 2. Organization Name:

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* 3. Email Address:

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* 4. Phone Number:

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* 5. I am interested in collaborating in the effort to create a Statewide Water Education Action Plan (SWEAP):

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* 6. We envision that Water Educator Network (WEN) members will be instrumental in building and activating SWEAP. Please indicate your interest in WEN membership below.

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* 7. Updates on the SWEAP Project will be disseminated through the WEN Newsletter list. If you want to ensure you are on this list, please check the box below. 

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* 8. My organization or myself provides water education opportunities for the following audiences: (Check all that apply)

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* 9. What concerns do you have about the process of creating a Statewide Water Education Action Plan, if any?

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* 10. Please list any past surveys, reports, efforts, etc. that you are aware of that WEco should consider as we are reviewing data:

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* 11. Please list the names, organizations and emails of others who you think would be essential to this process:

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* 12. I would most likely attend the collaborator input meeting in:

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* 13. Please leave any additional feedback you might have about SWEAP that were not addressed above:

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