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4. Please note that Indoor Water Conservation Kits are limited to one per household. Only residential customers of CVWD are eligible. Kits are not mailed out of state. You must be the homeowner owner to apply.

   Please fill out the form below to request an Indoor Water Conservation Kit.

6. Do you rent or own? *

   1. Rent

   1. Own

   *You must be the homeowner to apply for this program.

8. When was your property constructed?*

   1. 0-10 Years

   1. 11-20 Years

   1. 21-30 Years

   1. Not Sure
10. Is your home in an HOA?*

    1. Yes

    1. No

    1. Unsure
12. CVWD Account #*
14. First Name*
15. Last Name*
17. Phone*
18. Email*
20. Please provide your CVWD service address.
22. Service Address*
24. Service City*
25. Service State*
26. Service Zip*
28. Please provide your mailing address.
    Kits can only be mailed in California
30. Mailing Address*
32. Mailing City*
33. Mailing State*
34. Mailing Zip*
36. The Indoor Water Conservation Kit comes in a 12"x12"x4" box. If you have difficulty receiving large packages you may want to pick up your kit at one of our offices.

    All fields are required.

Leave This Blank:


38. 1. Receive an email copy of this form.
39. Email address

    This field is not part of the form submission.

40. Submit

* indicates a required field