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2. Required Workshop*

   By clicking "yes" I am certifying that I have attended the two-hour "landscape transformation" preparation workshop / class offered for free by the Waterwise Community Center / Chino Basin Water Conservation District. Attendance at this class is a REQUIREMENT before singing up for the Landscape Design Assistance Program.

   1. Yes, I have attended the required workshop.
4. Month you attended the workshop*
6. First Name*
7. Last Name*
9. Email*
10. Would you like to receive our monthly newsletter?

    The CBWCD newsletter provides district news, landscaping tips, and calendar reminders of upcoming workshops and events. Your email address will not be distributed or used for any other purpose.

    1. Yes

    1. No
12. Phone*
14. Participating Property Location
16. Address*
17. City*
19. Zip code*
21. Scheduling Your Appointment
    Please let us know if you have a preferred time of day for you appointment. Our appointments are primarily conducted during the week, and many participants take time off of work for their appointment. Appointments are made in the order requests are received. Our staff will be in touch with you to schedule your appointment date and time.
23. I prefer:*

    1. Morning (8 a.m.-12 p.m.)
    2. Afternoon (1 p.m.-5 p.m.)
24. Any additional comments or questions for our staff
Leave This Blank:


26. 1. Receive an email copy of this form.
27. Email address

    This field is not part of the form submission.

28. Submit

* indicates a required field