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2. Please fill out one application for each APN that you would like to enroll in the program.
4. 1. Applicant Information
6. First Name*
7. Last Name*
9. Company Name*
11. Mailing Address*
13. City*
14. State*
15. Zip*
17. Phone*
18. Email Address*
22. 2. Is the Applicant*

    1. Landowner

    1. Lessee

    
    

    If the Applicant is a Lessee, proceed to #3 and fill out the “Landowner Consent Form”. If the applicant is the landowner, proceed to #4.

26. 3. Lessee Information
28. First Name - Lessee
29. Last Name - Lessee
31. Mailing Address - Lessee
33. City - Lessee
34. State - Lessee
35. Zip - Lessee
37. Phone Number - Lessee
38. Email - Lessee
42. 4. Which of the following methods would you use to conserve canal water?*

    1. Land fallowing

    1. Switch to less water intensive crop

    1. Other
44. Other - Please specify*
48. 5. Participation period*

    1. Oct 2022 to Dec 2023

    1. Jan to Dec 2023

    1. Other
50. Other - Please specify*
54. 6. Land Details
56. APN to be enrolled in the program*
57. Number of acres*
58. Meter Number*
60. Does the APN have Well connection*

    1. Yes

    1. No
61. If yes, Well No
63. Did you farm this APN 3 of the past 5 years (2017 to 2021)*

    1. Yes

    1. No
64. If yes, type of crop(s)
68. 7. Other
70. Please list all APN’s that you own and lease even those that will not be enrolled in the program.*
74. Applicant Name*
75. Date
    Date

77. I certify that the information contained in this application is true and correct. I have read, understand and agree to the Colorado River Water Conservation Program Rules and Regulations.

79. Thank you for filling out the application.

    All applications are subject to review and approval. You will be notified at the e-mail provided above if you qualify for the program. For more information about this program, please visit: www.cvwd.org/ConserveCRW

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81. 1. Receive an email copy of this form.
82. Email address

    This field is not part of the form submission.

83. Submit

* indicates a required field