How did you hear about the Every Drop Counts learning resource? SD email/newsletter School Administrator Colleague CRD website Another CRD program Other Enter other… I would like to borrow an Educator's Kit? Yes NoThe Educator's Kit includes lesson plans, activity sheets, assessment tools, Down the Drain and Back Again Video, Drip, Drip, Drop CD, books and other support materials I would like to pickup the following free resources for my school/ organization: (one copy of each school resource available per school) School: Every Drop Counts USB School: Waterproof Map "Greater Victoria Watersheds" School: Waterproof Map "Greater Victoria Water Supply" Students: Toilet Leak Detector Tests Showerhead Efficiency Tests Students: The Cost of Water Waste brochures Quantity of Student Packages: I would like to borrow an Educator's Kit and/or pick up Student Package materials from: 625 Fisgard Street, Victoria (CRD Headquarters) 479 Island Highway (CRD Integrated Water Services) 490 Atkins Avenue (CRD Parks) Date ( 8:30 am to 4:30 pm; Monday Friday) And return the Educator's Kit ( 8:30 am to 4:30 pm; Monday Friday) Name First Name Last Name I am an educator for School District 61 School District 62 School District 63 School District 64 School District 65 Independent School Home Schooling Student Teacher Other Enter other… School (if applicable) Email Phone Number Personal information contained on this form is collected under the authority of the Local Government Act and is subject to the Freedom of Information and Protection of Privacy Act. The personal information will be used for purposes directly associated with this project. Inquiries about the collection or use of information in this form can be directed to Glenn Harris, Senior Manager, Environmental Protection, Capital Regional District 250.360.3090. Thank you for your request. Confirmation will be sent to you via email within 3 business days. Questions? Please contact 250.474.9684 or education@crd.bc.ca