Sign Up: Free Countertop Water Filter Delivery
**For residents in the Mead, Nebraska community only**

Bold is offering residents of the Mead, Nebraska community whose water has been potentially impacted by contaminants from the AltEn ethanol plant pollution a free countertop water filter, to help protect their families from any possible health issues that could now be in their home tap water. 
(Background: https://www.sierraclub.org/nebraska/alten-crisis)

Sign up below to have a countertop water filter (it attaches directly to your faucet's spout) delivered to your home.

(Please also consider agreeing to be contacted in the future by a scientist with the local university who wants to study the impact these water filters may have on your water quality and health.)
Questions? mark@boldnebraska.org
Sign in to Google to save your progress. Learn more
First Name *
Last Name *
Email *
Street address *
City *
State *
Zip *
I would like a Aquasana Claryum countertop water filter delivered to my home. *
Required
I am also interested in receiving a like a shower head water filter. (We will follow up with you by email)
I am OK being contacted in the future by a local university scientist, who is researching how these water filters potentially impact your home water quality and health. *
Required
Any questions or comments?
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of Boldnebraska.org.