Berks Conservancy

State of the Environment Survey

Please enter the information indicated below.
First Name:
Last Name:
Home Phone:
Email Address:
emailaddress@xyz.com

Have you read the State of the Environment in Berks report?
Yes
No

If Yes, what area was of most interest to you?
Air
Energy
Land
Waste
Water
Other  

State the number one reason why you believe the State of the Environment in Berks program and GreenBerks.com is important for this community.
 

  • 50 characters left.

What would you like to see happen in Berks as a result of this program?
 

  • 350 characters left.

Give one example of how we can involve children with implementing recommendations found in the report.
 

  • 350 characters left.

Are you willing to support the program by:
Attending our annual breakfast event scheduled for November 10, 2010
Volunteering to help spread the word
Sending a GreenBerks.com link to all of your email contacts
Encouraging your social networking friends (Facebook, Twitter, etc.) to visit GreenBerks.com
Making a tax-deductible contribution through GreenBerks.com
Becoming a member of the Berks Conservancy
All of the above
Other  


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