Water for the Global Community Unit Request Form
Please fill out the questions below so that we can assess suitability
Email address *
What is the name of the community the unit will be located? *
Your answer
How many people will be served by the unit? *
What is the current state of potable water in the location? Please be as detailed as possible. *
Your answer
Would you want an electric or non-electric unit? *
What is the name of the person who would be responsible for the care of the unit? *
Your answer
What is the name of the organization who would be responsible for the care of the unit? *
Your answer
Please provide all contact information for all parties involved. *
Your answer
What port should the unit be shipped to for pick-up? *
Your answer
You would be required to arrange local delivery from the port to the final destination. Would you be able to coordinate this? *
We require periodic reports on the performance of the unit. Would you be able to provide this? *
We will require a water test before and after filtration. Would you be able to provide this? *
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