Water Sense - Fre Low-flow Showerhead Program

ShowerheadRegister here to receive your free low-flow showerhead kit (includes one roll of Telfon tape, one package of toilet leak detection tablets and one instruction flyer.) This program is available only to households serviced by the Beaver Valley Water System, one per household, available to the first 150 registrants on first-come first-served. March 1 – April 15, 2011 or while supplies last.

Complete this survey to register – you will be notified by email within two business days that your registration is validated. You will receive a coupon that you will use to redeem for your package. * denotes mandatory fields.

*First Name

 
Please enter your first name.

*Last Name

  
Please enter your last name.

*Email address

  
Please enter your Email address.Invalid format (ie: you@you.com)

*Street Address

  
Please enter your street address.

Mailing address (PO Box if applicable)

  

*City

  
Please enter your city.

*Postal Code

  
Please enter your postal code.
*Phone Number  
Please enter your phone number.
*Your Status  
Please select a valid item.Please select an item.
*Type of Home  
Please select a valid item.Please select an item.
*Age of Home (in years)  

*Number of people living full time in your home (enter 0 if none):		  
Adults 19 & Over
Please enter the number of
adults 19 & over. Enter 0 if none.Invalid format.		 Children under 2
Please enter the number of
children under 2. Enter 0 if none.Invalid format.

 
Children 3 – 12
Please enter the number of
children 3 - 12. Enter 0 if none.Invalid format.		 Children 13 - 18
Please enter the number of
children 13 - 18. Enter 0 if none.Invalid format.

*Number of bathrooms in your household   Please enter the number of bathrooms in your household.Invalid format.
*Number of showers in your household   Please enter the number of showers in your household.Invalid format.
Number of low-flow showerheads currently in your household  
*Type of hot water source  
Please select a valid item.Please select an item.
*Does your household have a water meter?  
*Primary heat source  
Please select a valid item.Please select an item.
Do you burn wood in woodstoves or fireplaces in your household?   Yes No
If you burn wood, how many cords of wood do you burn per winter?  
*In total, how many light bulbs in your household   Please enter the number of lightbulbs in your household.Invalid format.
In total, how many Compact Fluorescent light bulbs in your household  
*Number refrigerators   Please enter the number of refrigerators in your household.Invalid format.
Number Energy Star refrigerators  
How would you like to receive your coupon?   Regular Mail
e-Mail (requires printer)
*How did you hear about the program?  
Please tell us how you heard about the program.Please select an item.
*How do you water your lawn?  
Please tell us how you water your lawn.Please select an item.
Would you like to receive e-newsletters to help your household save energy and water?   Yes No




TERMS: This program is delivered by Climate Sense Environmental Services. By participating in this residential water-saving pilot program, you agree that all information you supply is true and accurate to the best of your knowledge and that you are expressly providing your consent to share such information only with FortisBC, Terasen Gas, Village of Fruitvale, RDCK, and the Beaver Valley Water System. For more information on Climate Sense Privacy Policy click here. Program delivery begins March 1- 31, 2011 but this program may end without notice and is limited to 150 total showerhead kits. Any participating registrations that do not qualify will be notified by email only. One showerhead kit per household. This program is available only to households serviced by the Beaver Valley Water System. Registrations for the program are accepted as first-come, first-served.