Notification for updates regarding woodsmoke reduction incentive programs. Survey

1.Contact Information(Required.)

First Name

Last Name

Email Address

Phone Number

2.Address

Street

Street Line 2 (Optional)

City/Town:

State:

ZIP:

Country:

3.Which wood burning heating device do you currently have and use? (Select all that apply)

Open hearth wood-burning fireplace

Fireplace with wood-burning insert or woodstove that is EPA certified

Fireplace with wood-burning insert or woodstove that is NOT EPA certified

Pellet stove

N/A - I do not have a wood-burning device

Other wood-burning heating device (please describe)

4.Additional Information (Optional)