JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
Eagle Creek Impacts
We want to hear from you about how you are impacted by this project, and what questions you have for Citizens Energy/Lebanon Utilities.
Find links and more information at linktree.com/protectpiketownship
Sign in to Google
to save your progress.
Learn more
First and Last Name
Your answer
Address
Your answer
Phone
Your answer
Email
Your answer
What questions do you have for Citizens Energy Group/Lebanon Utilities?
Your answer
How are you impacted?
Your answer
Would you consider sharing your story at an upcoming activity such as a meeting with elected officials, or on a social media post?
Yes
No
Maybe
Do you give us permission for Protect Pike Township and our partners at Sierra Club to contact you regarding the upcoming meeting with Citizens Energy and your Q&A?
*Welcome! By providing your email and/or mobile number you consent to receive email, cell phone and text communications from Sierra Club, the Sierra Club Foundation, Sierra Club PACs and Chapters concerning news, action opportunities, and other important information about the local Beyond Coal Campaign.
Yes
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of Sierra Club.
Does this form look suspicious?
Report
Forms
Help and feedback
Contact form owner
Help Forms improve
Report