### General Information Cont a ct Name(s) Please provide U.S. contacts if possible. This information is for internal use only; WaterSense will not share contact information. Name * Email * Telephone * Contact Type * To select multiple options: - Using Windows, hold Ctrl key and select multiple options with mouse. - Using a Mac, hold Command key and select multiple options with mouse. Contact Update? * Name Email Telephone Contact Type Contact Update? Please update your interests and preferences to receive more specific communications from WaterSense. 

### Wate r Sense Labeled Product Availability and Program Feedb ack Information on WaterSense's impact on the marketplace is vital to the conti nue d success of the program. Please provide data on product availability and promotion. Yes No Please enter a number without commas. To select multiple options: - Using Windows, hold Ctrl key and select multiple options with mouse. - Using a Mac, hold Command key and select multiple options with mouse.

To s elect multiple options: - Using Windows, hold Ctrl key and select multiple options Manufacturer Name on Partnership Agreement * **6 Please select**  **...**

**5**

**6 Please select**  **... Primary Contact**  **Reporting Technical** 

**6 Please select**  **...**

**5**

**6 Please select**  **... Primary Contact**  **Reporting Technical**  **6 Please select**  **...**

1a. Are you promoting your WaterSense labeled products to consumers or other stakeholders? * **n m**  **l k**  **j n**  **m l**  **k j**  1b. Please estimate the number of consumers reached in 2012 (e.g., through circulars, via the Web, etc.) * 1c. Please indicate how you are promoting your WaterSense labeled products. * **5**

**6 Please select**  **... On product packaging**  **On the product itself Brochures and other marketing materials**  Other description * 1d. Do you mention WaterSense or include the WaterSense promotional label or partner logo on your: **Please select ...**  **Print advertising Broadcast advertising**  **Web advertising** Page 1 of 2with mouse. - Using a Mac, hold Command key and select multiple options with mouse.

Ye s No To select multiple options: - Using Windows, hold Ctrl key and select multiple options with mouse. - Using a Mac, hold Command key and select multiple options with mouse.

3. Where can consumers find your WaterSense labeled products?

Yes No

P l ease go to the awards page for application materials and instructions. Award application materials will be ava i lable on the WaterSense partner website by February 1. 1e. Are you working with retailers and/or distributors to promote your WaterSense labeled products? * **n m**  **l k**  **j n** 

**m l**  **k j**  Which retailers/distributors are you working with? 2. Did your company participate in any WaterSense promotional campaigns last year? * **5**

**6 Please select**  **... Fix a Leak Week**  **2012 We**  **' re for Water**  **Peak water season outreach** Other description * Please elaborate on your company's participation * **5**

**6** Markets (e.g., city, state, or region) * Retailer/distributor company names * 4. On a scale of 1 to 5 (5 = most valuable), how valuable do you find the WaterSense program? *

**6 Please select**  **...** How has the WaterSense label added value? * **5**

**6** 5. On a scale of 1 to 5 (5 = most valuable), how valuable do you find the WaterSense partner website?* *

**6 Please select**  **...** 6. In the past year, how often have you visited the WaterSense partner website?* **6 Please select**  **...** 7. By submitting both your online and hard copy annual reporting forms, you will be eligible to apply for a 2013 WaterSense Partner of the Year award. WaterSense encourages all partners to apply regardless of company size. Are you interested in applying for an award this year? * **n m**  **l k**  **j n** 

**m l**  **k j**  Help us improve the awards program by telling us why you're not interested in applying for an award. * **5**

**6** 8. Please provide suggestions for improving the WaterSense program (e.g., general tools/materials, webinar topics, communications, Helpline, websites etc.) * **5**

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