10% Challenge Survey | Sustainable Warwick NY

Please note: There are two ways in which you can take this survey. First, you can download a copy (it's only one page, with seven questions). Kindly return the completed survey to a member of Sustainable Warwick or mail to Sustainable Warwick, P.O. Box 1270, Warwick NY 10990. Second, you can take the on-line version, below.

EmailMeForm

Sustainable Warwick's 10% Challenge Survey

Last October, The Town of Warwick’s three villages, seven hamlets, three school districts, and the Florida and Albert Wisner libraries agreed to support Sustainable Warwick’s 10% Challenge and committed to reducing their energy use.

Now Sustainable Warwick would like to hear from individuals, nonprofits, and businesses in the Town of Warwick that reduced energy use. Would you fill out the form below to help us understand what people have done to reduce energy use? Please return to a member of Sustainable Warwick or mail to Sustainable Warwick, P.O. Box 1270, Warwick NY 10990.

The details of this information will be kept private. We are interested in seeing how many people took steps to save energy, and approximately how much they saved. More information about saving energy can be found at http://sustainablewarwick.org. Thank you!

Before you take this quick survey, can you please confirm that you (or your business or non-profit organization) are located in the Town of Warwick? (Villages of Florida, Greenwood Lake, Warwick; hamlets of Amity, Bellvale, Edenville, Little York, New Milford, Pine Island, Sterling Forest) *

Yes

No
What is your zip code?
Did You Save Energy Since Last October? *

Yes

No
I reduced energy by (check as many as apply): Note: for MAC users, please hold down the "Apple" command key for more than one choice; for WIN users, hold down the "Control" key. *
Please specify any other ways in which you reduced energy consumption
Do you know how much energy you saved? (Gallons of fuel oil or gasoline, cubic feet or therms of natural gas, or kWh of electricity)?
Do you know the percentage of that form of energy you saved?
Optional question: May we contact you for a comment on the program? If so, can you please tell us your e-mail address or telephone number? The details of this information will be kept private. We are interested in seeing how many people took steps to save energy, and approximately how much they saved. More information about saving energy can be found at http://sustainablewarwick.org. Thank you!

EMF HTML Form
Report Abuse