Section 1: General Information 

Please fill out and submit this form electronically to WaterSense by Monday, April 1, 2013. If you have any questions, 

please refer to the Frequently Asked Questions page or email the WaterSense Helpline.

To save a draft of this application, select “Save my progress and resume later”. You will be prompted to provide an email 

address and password that you will use to re-enter the form. WaterSense does not have access to these passwords, 

so please keep your password in a safe place. 

Please fill in the following information as it relates to your organization: 

 Please enter a number without commas. 

 Please enter a number without commas. 

 Please enter a number without commas. 

 

 

Section 2: Eligibility 

Yes, our organization became a WaterSense partner prior to January 1, 

2013. Yes, our organization submitted a 2012 annual reporting form. 

Section 3: Organization Description 

 

Section 4: Written Statement 

If you haven’t done so already, please download, complete, and save your written statement. 

 Acceptable file formats: Word or PDF. 

Organization Name Please select... 

Number of Stores or Showrooms (if Applicable)

Number of Customers, Annually (Approximately) *

Number of Employees in the U.S. (Approximately) *

If your company has brick and mortar stores, please provide the percentage of stores that offered 

WaterSense labeled products in 2012:

By what percentage did your total WaterSense labeled stock assortment (online and in stores) increase 

from 2011 to 2012?

 

 

Phone * Format (xxx xxx xxxx) 

Fax 

Email * 

Contact Name (for awards-related communications) *

Title

Please verify your eligibility: * 



Briefly describe your organization in no more than 300 words. If selected to receive an award, this 

description may be used in recognition materials. *





Please upload your final written statement, in which you have addressed the evaluation criteria. *

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Retailer and Distributor - Awards Application 
Section 5: Supporting Materials 

Please note: WaterSense is no longer accepting hard copy supporting materials. Partners are also asked to limit their 

electronic supporting materials to 25 pages. Additional supporting materials will not be reviewed. 

 

Upload more supporting materials 

Please note: Individual files may not exceed 5 MB. Total file size may not exceed 20 MB. 

We understand that some high-resolution photos may be quite large and push your application over the 20 MB file size 

limit. Therefore, you may send up to 10 additional photos of your 2012 WaterSense-related activities to 

watersenseawards@erg.com. These photos may be used in recognition materials if your organization is selected for an 

award. Materials other than photos sent to this email address will not be reviewed with your application. 

Your application form, including the written statement and supporting materials, must be submitted by Monday, April 1, 

2013 to be considered for an award. 

On the following page, you will be asked to review your responses. You must select "confirm" at the bottom of the 

following page to submit your award application to WaterSense. 

Please note, you may need to try different printer settings or print as a PDF to print the full report for your records. We 

apologize for any inconvenience. 

Need assistance with this form? 

Please upload any supporting materials that help demonstrate the accomplishments described in your 

written statement. Including supporting materials is not required, but is strongly encouraged. To upload 

additional supporting materials, please use the "Upload more supporting materials" link below the first 

record.

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