CRWC Stormwater Education Display Reservation

Please fill out the following information to reserve the CRWC stormwater education display

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* 1. Your Name (First & Last):

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* 2. Your Contact Information

email:

phone number:

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* 3. Community/Municipality:

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* 4. Please mark the start and end date of the time you wish to reserve the display

Start date:

Date

End date:

Date

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* 5. Someone from my community can pick up the display from the CRWC office.

Yes, we can arrange that.

No, we need it delivered.

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* 6. If you are unable to pick up the display, where would you like CRWC to drop it off?

Name of Location:

Street Address:

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* 7. During what hours should CRWC come to drop off and pick up the display?

Earliest time:

Time

AM/PM

Latest time:

Time

AM/PM

Thank you for reserving the CRWC Stormwater Education display!

A CRWC staff member will get back with you to confirm the dates and times you submitted.

If you have questions, please don't hesitate to call or email Pronoye Kapali
CRWC Watershed Program Specialist
pronoye@crwc.org // 248-601-0606 ext. 27

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