OMB Control Number 2040-0272 

 Approval Expires XXXX 

Professional Certifying Organization Partner Annual Reporting 

EPA WaterSense® Program Partners: Please complete and submit to WaterSense by March 1, 2011. 

Section I: General Information 

Organization Name: _____________________________________________________________________________ 

Contact Name: ____________________________ Email: ____________________________________________ 

Telephone: _______________________________ Fax: ______________________________________________ 

Name of program(s) with the WaterSense label: _______________________________________________________ 

Approximate number of professionals currently certified under WaterSense labeled program(s): __________________ 

Section II: Promotional and Recruitment Activities 

1. Please indicate what types of WaterSense promotional activities you conducted last year and what you plan to 

 implement in 2011. 

Activities 2010 2011 

Let the public know that they can save water—and money on their utility bills—by 

hiring WaterSense irrigation partners who have completed your labeled program. 

Publicize your program in newsletters, local newspapers, Web sites, public 

service announcements, and at conferences. 

 

Use the WaterSense label in conjunction with information about your certification 

program. 

 

Include a link to the WaterSense Web site on your Web site, along with a 

description of the WaterSense program and information on the role of certified 

professionals. 

 

Educate irrigation professionals on the WaterSense program during instruction 

provided to prepare for the certification exam. 

 

Include information about WaterSense in a brochure or fact sheet about your 

certification program. 

 

At the location of the certification exam, provide exam takers with a copy of the 

WaterSense Smart Way to Water Efficient Landscapes brochure. 

 

Other:  

Section III: WaterSense Program Feedback (Optional)

In the interest of serving you better, EPA would like to learn more about your opinions regarding the WaterSense 

program and information needs. Please complete the following section to provide feedback to EPA. 

1. On a scale of 1 to 5 (5 = most valuable), how valuable do you find the WaterSense program? Value: ____________ 

 How has WaterSense added value? _______________________________________________________________ 
2. On a scale of 1 to 5 (5 = most valuable), how valuable did you find the materials from the tool kit? 

 Value: ______ 

3. Please provide suggestions for improving the WaterSense program (e.g., tools/materials, communications, Helpline, 

Web site, etc): ________________________________________________________________________________ 

 ____________________________________________________________________________________________ 

 ____________________________________________________________________________________________ 

Please submit to the WaterSense Helpline by March 1, 2011. 

Fax: (703) 841-1440

Mail: 2300 Wilson Blvd., Ste. 350, Arlington, VA 22201 

Electronically: If you have Adobe Acrobat Standard or Professional, you can complete the form electronically and 

e-mail it to watersense@epa.gov. Acrobat Reader users must print forms after completing and fax or mail them. 

Contact the WaterSense Helpline at (866) 987-7367 if you have any questions about how to complete this form or 

submission instructions. 

EPA Form Number 6100-XX 

The public reporting and record keeping burden for this collection of information is estimated to average 18 hours per response. Send comments on the Agency's 

need for this information, the accuracy of the provided burden estimates, and any suggested methods for minimizing respondent burden, including through the use 

of automated collection techniques to the Director, Collection Strategies Division, U.S. Environmental Protection Agency (2822T), 1200 Pennsylvania Ave., NW, 

Washington, D.C. 20460. Include the OMB control number in any correspondence. Do not send the completed annual data form to this address.