Gilmer Park Area - Water Quality Survey
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How Concerned Are You About the Quality of Your Drinking Water? *
1=Very Much, 3=Somewhat, 5=Not At All
Very Much
Not At All
Are You Interested in Improving the Quality of Your Drinking Water? *
1=Very Much, 3=Somewhat, 5=Not At All
Very Much
Not At All
Are You Interested in Receiving Public Water? *
1=Very Much, 3=Somewhat, 5=Not At All
Very Much
Not At All
Are You Willing to Pay $50 - $70 Per Month (based on 75% to 90% participation) for Safe, Clean Water? *
1=Very Much, 3=Somewhat, 5=Not At All
Very Much
Not At All
How Important is Safe, Clean Drinkning Water to You? *
1=Very Much, 3=Somewhat, 5=Not At All
Very Much
Not At All
Please Provide Any Additional Comments You May Have:
(Maximum 250 Characters)
Thank you for your participation.  St. Joseph County values your input and County Officials will use your comments to help guide the decision making process toward reliable, clean and safe drinking water for you.
Your Name
Street Address: *
Mailing Address: *
(If different from above)
Phone Number:
Email Address:
Disclaimer:
Personal information provided in this survey will be used solely for the purpose of  verifying residency and assisting St. Joseph County with their decision making process.  Provided information will not be used for any other reason nor will it be disseminated, provided or sold to any third party.
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