Xylem Watermark and Planet Water Foundation - Stakeholder Project Sponsorship

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* 1. How did you find out about the Xylem Watermark & Planet Water Foundation Stakeholder Project Sponsorship Program?

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* 2. Contact information

Name

Company

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

Country

Email Address

Phone Number

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* 3. Please select the type of Planet Water Foundation system(s) you will support.

AquaTower

AquaHome

AquaBlock Emergency Response Fund

AquaTowers and/or AquaHomes

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* 4. Please select the geography where the project(s) should be deployed

Siem Reap, Cambodia: Available for AquaTowers and/or AquaHomes

Thane-Palghar District, India: Available for AquaTowers and/or AquaHomes

Lombok, Indonesia: Available for AquaTowers Only

Greater Manila, Philippines: Available for AquaTowers Only

N/A: AquaBlock Sponsorships

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* 5. Please select the preferred donation method

Directly sponsoring the full cost of a project(s) via Community Impact Portal

Fundraising to support a project(s) via Classy Page

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* 6. Do you plan to travel to install this project?

Please note:
Sponsors of an AquaTower or Multi-Product projects have the option to plan a volunteer trip to deploy the products.

Planet Water Foundation and Xylem Watermark need to be aware of travel plans, but do not cover travel costs or book travel arrangements.

Yes

No

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* 7. Please provide any additional comments and questions you have for the Planet Water Foundation and Xylem Watermark Team