Project Water Request Form 2009!  Please complete the following form  and then click on SUBMIT at the bottom of the page.

Organization / Agency Program Name
General Org. Email
# of Bottles Requested
Desc. of how you will be distributing the water
Would your Org. benefit from a water filtration system?
Descr. how could you benefit from a water filtration system?
Your Full Name
Your Direct Email Address
Executive Director's Email Address
Telephone
Fax
Street Address
City
Province
Postal Code

Having trouble submitting this form?
Please Click Here to E-mail us directly with your entry and feedback

Please Note That All Donation Requests Must Be Submitted By: Friday June 19, 2009.

More information regarding Pick Up Dates & Times will be emailed when the water has been allocated. 

*** Upon submitting this form, it is necessary to add: bg@bargainsgroup.com to your email address book / white list / accepted list to ensure you receive this and other email Donation alerts.

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