(866) WTR-SENS (987-7367) · www.epa.gov/watersense · watersense@epa.gov

2009 WaterSense® Awards

OMB Control Number 2040-0272

Approval Expires 01/31/2010

The public reporting and recordkeeping burden for information collection requirements associated with the awards application for each respondent is estimated to 

be 21 hours. An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB 

control number. 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 form to this address. 

Instructions

The U.S. Environmental Protection Agency’s WaterSense program is pleased to recognize the 

accomplishments of its partners. Partners in each category contribute to our shared mission of 

protecting the future of our nation’s water supply by promoting water-efficient products, services, and 

practices. 

To apply for a WaterSense award, please complete the following steps:

1. Ensure Eligibility. To be eligible for an award, you must have become a WaterSense partner 

prior to January 1, 2009. In addition, you must have submitted your 2009 WaterSense annual 

reporting form.

2. Complete the Awards Application Form. Please fill out the brief application form, including 

your contact information, eligibility confirmation, and a description of your organization.

3. Compose a Written Statement. Please prepare a short, written statement that addresses each 

of the evaluation criteria for your award category. Your written statement must be no more 

than five (5) pages in length. (Please organize and label your responses to coincide with the 

evaluation criteria categories). Your responses should address WaterSense-related efforts and 

accomplishments that you conducted in 2008. 

4. Compile Supporting Materials. Please include sample or supporting materials that clearly 

demonstrate how your organization has supported the WaterSense program mission. The 

materials should complement your written statement and provide WaterSense with tangible 

examples of your outreach activities. Please refer to the category-specific instructions for your 

sector for a list of examples. 

5. Submit Two (2) Copies of the Complete Award Application Package. Mail two (2) copies 

of your complete application package, including the application form, written statement, and 

sample or supporting materials to:

WaterSense

c/o ERG

2300 Wilson Blvd., Suite 350

Arlington, VA 22201

Your application package must be postmarked no later than April 10, 2009. 

If you have questions, please contact the WaterSense Helpline by e-mail at watersense@epa.gov or 

by calling toll free: (866) WTR-SENS (987-7367). 
Promotional Partner of the Year Application

Organization Name: _____________________________________________________________________

Number of Employees:___________________________________________________________________

Population Served or Number of Members (if applicable): ______________________________________

Contact Name: _________________________________________________________________________

Contact Title:___________________________________________________________________________

Contact Phone:__________________ Fax: _________________ E-mail: ___________________________ 

1. Please verify your eligibility:

❏ Joined WaterSense partnership prior to January 1, 2009? Date joined:_________________

❏ Submitted 2009 annual reporting form? Date submitted: _____________

2. Please provide a brief description (no more than 300 words) about your organization. If you are 

selected to receive an award, this text will be the basis for describing your organization in award 

recognition materials. Attach an additional page if necessary.

______________________________________________________________________________________

______________________________________________________________________________________

______________________________________________________________________________________

______________________________________________________________________________________

______________________________________________________________________________________

______________________________________________________________________________________

3. To complete the application process, carefully 

review the written statement instructions 

and evaluation criteria, prepare your written 

statement, and submit your complete 

application package by April 10, 2009.

EPA Form Number 6100-17. (866) WTR-SENS (987-7367) · www.epa.gov/watersense · watersense@epa.gov

2009 WaterSense® Awards

Important Dates

Annual reporting form deadline: March 2, 2009 

Application deadline: April 10, 2009 

Award winner notification: June 19, 2009 

Recognition ceremony: October 7-9, 2009

OMB Control Number 2040-0272

Approval Expires 01/31/2010
Written Statement Instructions

Please compose your written statement by addressing each of the following evaluation criteria based 

on your activities in 2008. Organize and label your statement using the categories listed below (e.g., 

“Education and Outreach Activities”). In total, your written statement must be no more than five (5) 

pages in length, not including sample or supporting materials. 

To strengthen your application: 

•	 Include measurable results wherever possible. For promotional partners, this might include the

number of brochures distributed, number of media impressions, value of incentives, survey 

results, and estimated water savings due to WaterSense-specific promotional efforts.

•	 Include sample or supporting materials in your application package to thoroughly demonstrate

your accomplishments. For promotional partners, these materials might include sample brochures, 

articles, newsletters, photos, rebate forms, or other materials showcasing the WaterSense marks. 

•	 Organize your written statement to address the evaluation criteria and avoid double counting

your activities across categories. 

WaterSense will evaluate your application based on your written statement in response to the criteria 

below. The point values following each category indicate the maximum potential value for all activities 

within that category. 

Evaluation Criteria

1. Education and Outreach Activities (50 points)

•	 Describe how you conducted (including quantity and reach) WaterSense related consumer 

and/or member outreach activities. For example, this might include developing Web sites, 

writing and publishing newsletters, managing listservs, using billstuffers, producing public 

signage, giving presentations, and organizing events that promoted WaterSense.

•	 Describe how you conducted WaterSense related media activities (including quantity and 

reach) that resulted in increased public awareness about water efficiency and the WaterSense 

program. For example, this might include pitching public service announcements, creating 

and/or publishing articles or advertisements in newspapers, journals, or broadcast media that 

promoted WaterSense.

2. Measurable Results (20 points) 

•	 Describe how you measured the effectiveness of your WaterSense related promotional

activities and include those metrics.

•	 Demonstrate how you have increased public awareness of the WaterSense brand and how you

measured that increase in awareness. 
3. Incentive Programs (20 points) 

•	 Describe relevant incentive programs or events your organization sponsored or promoted,

which encouraged consumers to purchase WaterSense labeled products.

•	 Highlight quantifiable details. For example, this might include the number of times you offered

incentives, the number of recipients participating in incentive programs, the value of your 

incentives, and the number of products the incentives covered. 

4. Strategic Collaboration (10 points)

•	 Describe how you have collaborated with manufacturers, retailers, builders, landscape

irrigation professionals, and other groups to promote WaterSense messaging. Include how 

your organization selected potential partners and the value the collaboration brings to the

WaterSense program in your region.