Qleanse Ditch The Wipes Partnership Program
Thank you for your interest in the initiative to help residents ditch their wipes and make the switch to a safer alternative with Qleanse. Please complete the following information to help determine if this partnership is a good fit for your city and to help us build custom program offers. Product samples limited to wasterwater utility personnel.
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Διεύθυνση ηλεκτρονικού ταχυδρομείου *
Name (First & Last) *
Name of Company/Wastewater Utility *
Title/Position *
Phone Number *
Address *
How many residents does your wasterwater utility cover? *
Rate the effectiveness of the methods your city may have tried to increase awareness of the wet wipe issue
1 - Not Effective
2
3
4
5 - Very Effective
NA - Not Tried
TV News Education
Social Media Education
Newspaper Education
Online ads Education
Other efforts (describe in comments below)
Διαγραφή επιλογής
For "Other" above, please describe the issue
Estimate the yearly cost your city incurs to manage, prevent and repair sewer system damange caused by wet-wipes
Διαγραφή επιλογής
Which public location(s) would be ideal to place a disposal bin for your residents to trade in their wet wipes for Qleanse? *
Υποχρεωτική
Do you have any other questions or comments for us?
Υποβολή
Εκκαθάριση φόρμας
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